PCT、ET联合LPS检测在尿石症冲击波碎石术后尿路感染中的诊断价值

Value of PCT and ET combined with LPS detection in the diagnosis of urinary tract infection after shock wave lithotripsy for urolithiasis

目的分析降钙素原(PCT)、内毒素(ET)联合脂肪酶(LPS)检测在尿石症冲击波碎石术后尿路感染中的诊断价值。方法收集2018年3月至2021年3月河北北方学院附属第一医院收治的经冲击波碎石术治疗的尿石症患者168例,统计患者术后感染情况,对比感染组与未感染组PCT、ET、LPS表达水平;对感染组患者治疗后1 d、7 d PCT、ET、LPS表达水平;对比不同感染菌患者中PCT、ET、LPS表达水平;分析PCT、ET、LPS对患者术后尿路感染的诊断价值。结果168例患者术后发生感染35例,未感染133例。35例术后感染者中14例为革兰阳性菌,21例为革兰阴性菌。感染组PCT、ET、LPS表达水平显高于未感染组,差异有统计学意义(P<0.05);治疗后7 d患者PCT、ET、LPS表达水平明显低于治疗后1 d,差异有统计学意义(P<0.05);革兰阴性菌组PCT、ET、LPS表达水平明显高于革兰阴性菌,差异有统计学意义(P<0.05);依据ROC曲线可知,PCT+ET+LPS联合检测对患者术后尿路感染诊断敏感度和特异度分别为0.800、0.857,AUC=0.840(95%CI:0.757~0.922),明显高于三者单独诊断(P<0.05)。结论尿石症冲击波碎石术后尿路感染患者PCT、ET、LPS表达水平明显升高,三者均可为术后尿路感染情况提供参考,且联合诊断可有效提高诊断效能。

Objective To analyze the diagnostic value of procalcitonin(PCT),endotoxin(ET)combined with lipase(LPS)in urinary tract infection after shock wave lithotripsy for urolithiasis.Methods 168 patients with urolithiasis treated by shock wave lithotriptomy in our hospital from March 2018 to March 2021 were collected,and their postoperative infection was analyzed.The expression levels of PCT,ET and LPS were compared between the infected group and the uninfected group.The expression levels of PCT,ET and LPS in the infected group a the day 1 and day 7 after treatment were compared;The expression levels of PCT,ET and LPS in patients with different infection bacteria were compared.The diagnostic value of PCT,ET and LPS in patients with postoperative urinary tract infection was analyzed.Results Among the 168 patients,35 had postoperative infection and 133 had no infection.Among the 35 cases of postoperative infection,14 cases were gram⁃positive bacteria and 21 cases were gram⁃negative bacteria.The expression levels of PCT,ET and LPS in the infected group were significantly higher than those in the uninfected group(P<0.05).The expression levels of PCT,ET and LPS in 7 days after treatment were significantly lower than those in 1 day after treatment(P<0.05).The expression levels of PCT,ET and LPS in the gram⁃negative bacteria group were significantly higher than those in the gram⁃negative bacteria group(P<0.05).According to the ROC curve,the sensitivity and specificity of PCT+ET+LPS in the diagnosis of postoperative urinary tract infection were 0.800 and 0.857,respectively.AUC=0.840(95%CI:0.757~0.922),which was significantly higher than that of the three alone diagnosis(P<0.05).Conclusion The expression levels of PCT,ET and LPS in urinary tract infection after shock wave lithotripsy for urolithiasis were significantly increased.The three can provide reference for postoperative urinary tract infection,and the combined diagnosis can effectively improve the diagnostic efficiency.