前列腺增生术后尿路感染患者FGF10、NLR、CRP/ALB变化及其临床意义

Dynamic Changes and Clinical Significance of Blood FGF10,NLR,CRP/ALB in Patients with Urinary Tract Infection after Prostatic Hyperplasia Surgery

【目的】探讨前列腺增生(BPH)术后尿路感染患者成纤维细胞生长因子10(FGF10)、中性粒细胞/淋巴细胞比值(NLR)、C反应蛋白(CRP)/白蛋白(ALB)变化情况。【方法】选取2018年1月至2021年3月本院收治的164例BPH患者,均行经尿道前列腺等离子双极电切术,根据术后是否发生尿路感染将其分为感染组(n=33)和未感染组(n=131)。比较两组基线资料、手术前后FGF10、NLR、CRP/ALB,分析BPH术后发生尿路感染的影响因素,评估FGF10、NLR、CRP/ALB对BPH术后发生尿路感染的诊断价值。【结果】两组患者年龄、手术时间、术前预防性使用抗生素比例、术前因尿潴留行导尿术比例比较,差异有统计学意义(P<0.05)。两组术后1 d、3 d、5 d的FGF10、NLR、CRP/ALB呈先升高后降低趋势,且均在术后3 d达到最高峰(P<0.05);感染组术后1 d、3 d、5 d的FGF10、NLR、CRP/ALB高于未感染组(P<0.05)。多因素Logistic回归分析显示,年龄、手术时间、术前预防性使用抗生素、术前因尿潴留行导尿术及术后3 d的FGF10、NLR、CRP/ALB是BPH术后发生尿路感染的重要影响因素(P<0.05)。ROC曲线分析显示,术后3 d的FGF10、NLR、CRP/ALB联合诊断BPH术后尿路感染的曲线下面积为0.913,显著优于单一指标(P<0.05)。致病菌为革兰氏阴性菌患者的FGF10、NLR、CRP/ALB显著高于革兰氏阳性菌(P<0.05)。【结论】BPH术后发生尿路感染的患者FGF10、NLR、CRP/ALB增高,动态联合监测三者可为临床诊治、致病菌类型区分提供参考。

【Objective】To investigate the dynamic changes of fibroblast growth factor 10(FGF10),neutrophil/lymphocyte ratio(NLR),and C-reactive protein(CRP)/albumin(ALB)in patients with urinary tract infection after prostatectomy for benign prostatic hyperplasia(BPH).【Methods】A total of 164 patients with BPH admitted to our hospital from January 2018 to March 2021 were selected,all of whom underwent transurethral plasma bipolar resection of the prostate.They were divided into an infected group(n=33)and an uninfected group(n=131)based on whether urinary tract infection occurred after the surgery.Compare the baseline data of two groups,FGF10,NLR,CRP/ALB before and after surgery,analyze the influencing factors of urinary tract infection after BPH surgery,and evaluate the diagnostic value of FGF10,NLR,CRP/ALB for urinary tract infection after BPH surgery.【Results】There were significant differences between the two groups in terms of age,operation time,proportion of prophylactic use of antibiotics before operation,and proportion of catheterization due to urinary retention before operation(P<0.05).The FGF10,NLR,CRP/ALB levels in both groups showed a trend of first increasing and then decreasing on the 1st,3rd,and 5th postoperative days,and both reached their peak on the 3rd postoperative day(P<0.05);The FGF10,NLR,CRP/ALB levels in the infected group were higher than those in the non infected group at 1 day,3 days,5 days after surgery(P<0.05).Multivariate logistic regression analysis showed that age,operation time,preoperative prophylactic use of antibiotics,preoperative catheterization due to urinary retention,and FGF10,NLR,CRP/ALB 3 days after operation were the important influencing factors for urinary tract infection after BPH(P<0.05).ROC curve analysis showed that the area under the curve of FGF10,NLR,CRP/ALB combined diagnosis of postoperative urinary tract infection in BPH at 3 days after surgery was 0.913,significantly better than a single indicator(P<0.05).The FGF10,NLR,CRP/ALB levels in patients with Gram negative bacteria were significantly higher than those with Gram positive bacteria(P<0.05).【Conclusion】Patients with urinary tract infections after BPH surgery have elevated levels of FGF10,NLR,and CRP/ALB.Dynamic combined monitoring of these three factors can provide reference for clinical diagnosis and treatment,as well as differentiation of pathogenic bacteria types.