术前血小板白细胞计数比作为良性前列腺增生术后发热预测因素的价值分析

Preoperative platelet leukocyte count ratio can be used as a predictor of postoperative fever after benign prostatic hyperplasia

目的探讨术前血小板白细胞计数比作为良性前列腺增生(BPH)术后发热的预测价值。方法根据术后并发症的有无,将20家医院收治的844例行经尿道前列腺等离子切除术(TUPKP)治疗的BPH病人分为两组,术后有并发症组118例,术后无并发症组726例。采用单因素分析及多因素Logistic回归分析比较两组术前年龄、身高、体重、BMI、血红蛋白、红细胞、中性粒细胞、淋巴细胞、血小板、白细胞、血小板白细胞计数比、游离前列腺特异性抗原/总前列腺特异性抗原(FPSA/TPSA)、国际前列腺症状评分(IPSS)评分和前列腺的体积对TUPKP术后发热的影响,然后再运用受试者工作特征曲线(ROC)分析其独立危险因素的敏感性、特异性和截点值。结果血小板白细胞计数比小于30(OR=13.812,P<0.05)及血小板数降低(OR=1.014,P<0.05)的病人术后发热风险增加,血小板白细胞计数比和血小板数的敏感性、特异性和截点值分别为64.8%、97%、27.054和76%、58.2%、146.500。结论血小板白细胞计数比及血小板数为BPH病人TUPKP术后发热的独立危险因素。

Objective To explore the ratio of platelet and white blood cell count as the predictive value of fever after BPH.Methods According to the presence or absence of postoperative complications,844 patients with benign prostatic hyperplasia(BPH)who underwent TUPKP treatment in 20 hospitals were divided into two groups.118 patients with postoperative complications and no postoperative complications group included 726 examples.Preoperative age,height,weight,BMI,hemoglobin,red blood cells,white blood cells,neutrophils,lymphocytes,platelets,white blood cells,platelet white blood cell count ratio,FPSA/TPSA,IPSS score,prostate volume were compared by Univariate and multivariate Logistic regression analyses for influence on postoperative fever between the two groups.Then receiver operating characteristic curve(ROC)was used to analyze the sensitivity,specificity and cut-off value of its independent risk factors.Results Patients with a platelet white blood cell count ratio of less than 30(OR=13.812,P<0.05)and a decreased platelet count(OR=1.014,P<0.05)had a greatly increased risk of postoperative fever,the sensitivity,specificity and cut-off values of platelet white blood cell count ratio and platelet count were 64.8%,97%,27.054 and 76%,58.2%,and 146.500,respectively.Conclusion Platelet white blood cell count ratio and platelet count were independent risk factors for fever after TUPKP in BPH patients.