输尿管结石术后泌尿系统感染影响因素及TGF-β1、Smads表达

Influencing factors for postoperative urinary system infection and expressions of TGF-β1,Smads in ureteral calculi patients

目的探讨输尿管结石(CU)患者术后泌尿系统感染的影响因素及转化因子-β1(TGF-β1)、果蝇同源信号蛋白(Smads)水平变化。方法选取2020年1月-2021年6月日照市中心医院泌尿外科收治的98例行输尿管硬镜钬激光碎石术CU患者,根据术后是否出现泌尿系统感染分为感染组15例和未感染组83例,分析感染患者中段尿标本检出病原菌分布,多因素Logistic回归分析CU术后泌尿系统感染的影响因素,检测血清Smads及TGF-β水平。结果15例感染患者共分离出24株病原菌,其中革兰阴性菌15株,占比62.50%;多因素Logistic回归分析显示,年龄≥60岁、合并糖尿病、双J管留置时间≥7 d、ALB水平<30 g/L均为CU患者术后泌尿系统感染的独立影响因素(P<0.05);感染组患者术后血清Smad1、Smad7、TGF-β1水平高于未感染组,Smad4水平低于未感染组(P<0.05)。结论年龄、合并糖尿病、双J管留置时间、ALB水平均为CU患者术后泌尿系统感染的影响因素,感染可引起患者血清TGF-β1和Smads水平异常。

OBJECTIVE To explore the influencing factors for postoperative urinary system infection in patients with ureteral calculi and observe changes of transforming growth factor-β1(TGF-β1)and Drosophila homologous signaling protein(Smads).METHODS A total of 98 patients with ureteral calculi who underwent ureteroscopic holmium laser lithotripsy in urology department of Rizhao Central Hospital from Jan 2020 to Jun 2021 were enrolled in the study and divided into the infection group with 15 cases and the no infection group with 83 cases according to the status of postoperative urinary system infection.The distribution of pathogens isolated from midstream urine specimens of the patients with infection was observed,multivariate logistic regression analysis was performed for the influencing factors for the postoperative urinary system infection,and the levels of serum Smads and TGF-βwere detected.RESULTS Totally 24 strains of pathogens were isolated from the 15 patients with infection,15(62.50%)of which were gram-negative bacteria.Multivariate logistic regression analysis showed that the no less than 60 years of age,complication with diabetes mellitus,double-J tube indwelling time no less than 7 days and ALB level less than 30g/L were the independent influencing factors for postoperative urinary system infection in the patients with ureteral calculi(P<0.05).The levels of postoperative serum Smad1,Smad7 and TGF-β1 of the infection group were higher than those of the no infection group,while the Smad4 level of the infection group was lower than that of the no infection group(P<0.05).CONCLUSION The age,complication with diabetes mellitus,double-J tube indwelling time and ALB level are the influencing factors for the postoperative urinary system infection in the patients with ureteral calculi.The infection may lead to the abnormal change of serum TGF-β1 and Smads levels.