输尿管镜碎石术后发热性尿路感染危险因素及血清β防御素2高迁移率族蛋白B1 Toll样受体4早期预测价值

Risk factors of febrile urinary tract infection after ureteroscopic lithotripsy and the early prediction value of serumβ-defencin 2,HMGB1 and TLR4

目的 探讨泌尿结石疾病采取输尿管镜碎石术治疗术后发生发热性尿路感染的相关危险因素,观察血清β防御素2、高迁移率族蛋白B1(HMGB1)以及Toll样受体4(TLR4)对早期预测尿路感染的价值。方法 回顾性分析122例行输尿管镜碎石术治疗者的临床资料,根据术后是否发生发热性尿路感染分成感染组与未感染组,记录患者资料,分析危险因素,此外采集2组血液分离血清,测定血清β防御素2、HMGB1、TLR4水平。结果 术后35例(28.7%)发生发热性尿路感染,多因素分析显示年龄≥60岁、手术时间≥60 min、泌尿道手术史、合并糖尿病、导尿管留置时间≥72 h、住院时间≥7 d均是输尿管镜碎石术患者术后发热性尿路感染独立危险因素(P=0.023、0.014、0.016、0.019、0.008、0.011,OR值=2.154、3.021、2.451、2.331、2.025、2.415);感染组血清β防御素2、HMGB1、TLR4检测水平高于未感染组(t=10.48、28.47、22.86,P<0.05)。结论 输尿管镜碎石术,年龄、手术时间、泌尿手术室、合并糖尿管、导尿管留置与住院时间为术后发热性尿路感染的相关危险因素,需加强防范,术后通过检测血清β防御素2、HMGB1、TLR4水平对早期预测感染价值突出,值得推广。

Objective To investigate the risk factors of urinary toroidal diseases after the treatment of thermal urinary tract infection after ureter mirror and observe the early prediction value of serumβ-defensin 2,high mobility ratio protein B1(HMGB1)and Toll-like receptor 4(TLR4).Methods The clinical data of 122 cases ureter mirror therapists were retrospectively analyzed.According to the postoperative system,it was divided into infected group and the unhal group.Patient data were recorded and risk factors were analyzed.In addition,two blood samples were collected and serum levels ofβdefensin 2,HMGB 1 and TLR 4 were measured.Results Febrile urinary tract infection occurred in 35 patients(28.7%).The multi-factor analysis showed age≥60 years old,surgical time≥60 min,urinary tract surgery,combined diabetes,catheter indwelling time≥72 h,and hospital stay≥7d were independent risk factors for autopilot urinary tract infection after ureteroscopic patients.The serumβ-defensin 2,HMGB1 and TLR4 detection levels were significantly higher than those of the uninfected group(P<0.05).Conclusion Ureteroscopic mirror,age,surgical time,urinary operating room,combined diabetes,poor urine indwelling and hospitalization time can be related risk factors for postoperative healing urinary tract infections,need to strengthen prevention.Postoperative serumβdefensin 2,HMGB1,and TLR4 levels have highlighted early prediction infection,it is worth promoting.