体外冲击波碎石对茚地那韦相关泌尿结石患者PCT、肾功能及炎性指标水平的影响

Effects of extracorporeal shock wave lithotripsy on PCT,renal function and inflammatory index levels in patients with indinavir-related urinary calculi

目的探讨体外冲击波碎石术(ESWL)对茚地那韦药物性泌尿系结石患者降钙素原(PCT)、肾功能及炎性指标水平的影响,为临床实践提供参考依据。方法选取本院泌尿外科2017年1月—2021年1月收治的泌尿结石患者77例进行回顾性分析,按年限将其分成对照组(38例,非茚地那韦所致泌尿系结石患者)和观察组(39例,茚地那韦相关泌尿系结石患者)。治疗前、治疗后7 d,比较两组血清PCT、C反应蛋白(CRP)、血肌酐(Scr)、尿酸(UA)、尿肾损伤分子-1(Kim1)水平,疼痛视觉横拟评分(VAS)及IgG、IgM、丙二醛(MDA)、超氧化物歧化酶(SOD)水平。结果两组治疗后7天时的血清PCT、CRP表达较治疗前均明显降低,且观察组改善程度高于对照组(P<0.05)。对照组患者治疗后肾功能指标尿Kim-1、Scr及BUA明显优于观察组(P<0.05)。观察组治疗前后VAS评分与对照组无统计学差异(P>0.05),但术中出血量及麻醉诱导后20 min平均动脉压(MAP)明显优于对照组。观察组患者治疗后7 d硒半胱氨酸(GSH-Px)、SOD明显优于对照组和本组治疗前(P<0.05)。结论对茚地那韦药物性泌尿系结石患者实施ESWL治疗,能有效降低血清PCT、CRP表达,改善肾功能指标,减少术中出血量,降低炎性指标水平,临床疗效较好。

Objective To investigate the effects of extracorporeal shock wave lithotripsy(ESWL)on procalcitonin(PCT),renal function and inflammatory index levels in patients with indinavir-induced urinary calculi so as to provide reference for clinical practice.Methods A total of 77 patients with urinary calculi admitted to the Department of Urology of our hospital from January 2017 to January 2021 were selected for retrospective analysis.They were divided into control group(38 cases,non-indinavir related urinary calculi)and observation group(39 cases,indinavir-related urinary calculi)according to the years of the disease.Before treatment and 7 days after treatment,the serum levels of PCT,CRP,Scr,UA,Kim1,VAS scores,and IgG,IgM,MDA,and SOD levels were compared between the two groups.Results The expressions of serum PCT and CRP at 7 days after treatment in the two groups were significantly lower than those before treatment,and the improvement degree of the observation group was significantly higher than that in the control group(P<0.05).The renal function indexes of urine Kim-1,Scr and BUA in the control group after treatment were significantly better than those in the observation group(P<0.05).However,there was no significant difference in VAS score between the two groups before and after treatment(P>0.05),but the intraoperative blood loss and MAP 20 min after induction of anesthesia were significantly better than those in the control group.Seven days after treatment,GSH-Px and SOD were significantly better in the observation group than in the control group and before treatment(P<0.05).Conclusion ESWL treatment for patients with indinavir-induced urinary calculi can effectively reduce the expressions of serum PCT and CRP,improve renal function indexes,reduce intraoperative blood loss,and reduce the level of inflammatory indexes;the clinical effect is good.