血清降钙素原早期诊断经皮肾镜碎石术后尿脓毒血症的临床意义

Clinical Significance of Serum Procalcitonin in Early Diagnosis of Urosepsis after Percutaneous Nephrolithotomy

目的:探究血清降钙素原(PCT)早期诊断经皮肾镜碎石术(PCNL)后尿脓毒血症的临床意义。方法:回顾性分析2018年4月-2021年4月于新余市人民医院泌尿外科行PCNL治疗的患者70例,其中术后出现尿脓毒血症患者35例纳入观察组,术后未出现尿脓毒血症患者35例纳入对照组。采集血液标本送检,测定血清中PCT、C反应蛋白(CRP)及白细胞(WBC)水平。比较两组手术前后血清PCT、CRP及WBC水平,分析血清PCT、CRP及WBC在早期PCNL后尿脓毒血症的诊断价值。结果:术前,两组PCT、CRP及WBC水平比较,差异均无统计学意义(P>0.05);术后,观察组PCT、CRP及WBC水平均高于对照组,差异均有统计学意义(P<0.05)。ROC曲线分析可见,PCT在PCNL后尿脓毒血症患者诊断中AUC值高于CRP及WBC,差异均有统计学意义(P<0.05)。结论:PCT在诊断早期PCNL后尿脓毒血症中具有较高的临床应用价值,依据其水平变化能够准确判断患者病情进展情况,为临床诊疗提供可靠参考依据,值得推广应用。

Objective:To explore the clinical significance of serum procalcitonin(PCT)in early diagnosis of urosepsis after percutaneous nephrolithotomy(PCNL).Method:A retrospective analysis was performed on 70 patients who underwent PCNL treatment in Department of Urology,Xinyu People’s Hospital from April 2018 to April 2021.Among them,35 patients with postoperative urosepsis were included in the observation group,and 35 patients without postoperative urosepsis were included in the control group.Blood samples were collected and sent for inspection,and tested forthe levels of serum PCT,C reactive protein(CRP)and white blood cells(WBC).The levels of serum PCT,CRP and WBC before and after operation were compared between the two groups,and the diagnostic value of serum PCT,CRP and WBC in urosepsis after early PCNL were analyzed.Result:Before operation,there were no significant differences in the levels of PCT,CRP and WBC between the two groups(P>0.05);after operation,the levels of PCT,CRP and WBC in the observation group were higher than those in the control group(P<0.05).ROC curve analysis showed that the AUC value of PCT in the diagnosis of urinary sepsis after PCNL was higher than that of CRP and WBC,the differences were statistically significant(P<0.05).Conclusion:PCT has a high clinical application value in the diagnosis of early urosepsis after PCNL,it can accurately judge the progress of the patient’s disease according to its level change,and provide a reliable reference for clinical diagnosis and treatment,which is worthy of popularization and application.