血清视黄醇结合蛋白4、胱抑素C在肾结石术后尿路感染中表达及临床意义

Expression and clinical significance of serum RBP4 and CysC in urinary tract infection after kidney stones surgery

目的探究血清视黄醇结合蛋白4(RBP4)、胱抑素C(CysC)在肾结石术后尿路感染中表达及临床意义。方法选取2019年7月至2021年6月德阳市第二人民医院泌尿外科因肾结石行手术的157例病人为研究对象,根据术后是否发生尿路感染分为感染组(81例)与非感染组(76例);检测感染组病人尿液中病原菌种类;比较两组血清中RBP4、CysC水平,并分析影响术后尿路感染发生的相关因素。结果81例肾结石术后尿路感染病人的尿液标本中检测出79株病原菌,其中67.09%为革兰阴性菌,29.11%为革兰阳性菌,真菌仅占3.80%;感染组血清RBP4(17.29±4.73)mg/L、CysC(1.58±0.33)mg/L水平高于未感染组RBP4(11.74±2.01)mg/L、CysC(1.19±0.14)mg/L水平(P<0.05);感染组血清RBP4与CysC水平呈正相关(r=0.80,P<0.001);术前留置输尿管支架管、手术时间≥60 min、术前无抗生素使用、术后输尿管导管留置时长≥7 d以及RBP4、CysC是影响尿路感染发生的独立危险因素(P<0.05)。结论血清RBP4、CysC在肾结石术后发生尿路感染病人血清中高表达,血清RBP4与CysC水平呈正相关,RBP4、CysC水平变化均与术后发生尿路感染有关。

Objective To explore the expression and clinical significance of serum retinol binding protein 4(RBP4)and Cystatin C(CysC)in urinary tract infection after kidney stones surgery.Methods One hundred and fifty-seven patients who underwent surgery for kidney stones in the Dedpartment of Urology,the Second People's Hospital of Deyang City from July 2019 to June 2021 were selected as the research objects.According to whether the patients were complicated with urinary tract infection,they were assigned into infection group(81 cases)and non-infection group(76 cases).The types of pathogenic bacteria in the urine of the infection group were detected;the serum levels of RBP4 and CysC between the two groups were compared,and the related factors affecting the occurrence of postoperative urinary tract infection were analyzed.Results A total of 79 pathogenic bacteria were isolated in the urine of 81 patients with urinary tract infection after renal calculus surgery,of which 67.09%were Gram-negative bacteria,29.11%were Gram-positive bacteria,and fungi accounted for only 3.80%;the levels of serum RBP4(17.29±4.73)mg/L and CysC(1.58±0.33)mg/L in the infection group were higher than those in the non-infection group RBP4(11.74±2.01)mg/L and CysC(1.19±0.14)mg/L(P<0.05);there was a positive correlation between the expression of serum RBP4 and CysC in infection group(r=0.80,P<0.001);preoperative indwelling of ureteral stents,operation duration≥60 min,preoperative no antibiotics,postoperative indwelling ureteral catheter duration≥7 d,RBP4 and CysC were the independent risk factors for postoperative urinary tract infection(P<0.05).Conclusion The serum levels of RBP4 and CysC are significantly increased in patients with urinary tract infection after renal calculus surgery,and RBP4 are positively correlated with the level of CysC.The changes of RBP4 and CysC levels are related to postoperative urinary tract infection.