PCT、IL-6、IL-8、IFN-γ与泌尿外科患者导尿管相关泌尿道感染的关系

Relationship between PCT,IL-6,IL-8,IFN-γand urinary tract infection in urology patients

目的探讨泌尿外科患者血清中降钙素原(PCT)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、γ干扰素(IFN-γ)水平与发生导尿管相关泌尿道感染(CAUTI)的关系。方法选取2019年3月至2020年7月本院收治的使用导管辅助治疗的135例患者为研究对象,按照是否出现相关泌尿道感染将患者分为对照组(84例)与感染组(51例)。比较两组患者血清中的PCT、IL-6、IL-8、IFN-γ水平;分析PCT、IL-6、IL-8、IFN-γ水平与泌尿外科患者发生CAUTI的相关性;绘制受试者工作特征(ROC)曲线比较联合诊断对泌尿外科患者发生CAUTI的诊断价值;采用单因素分析影响泌尿外科患者发生CAUTI的相关因素;采用多因素logistic回归分析影响泌尿外科患者发生CAUTI的独立危险因素。结果与对照组相比,感染组患者的血清PCT、IL-6、IL-8、IFN-γ水平显著升高(均P<0.05);Spearman相关系数分析显示PCT、IL-6、IL-8及IFN-γ水平与泌尿外科患者发生CAUTI呈正相关(均P<0.001);通过ROC曲线分析显示四种指标联合诊断的曲线下面积高于两种指标联合诊断(P<0.05);单因素分析结果显示影响泌尿外科患者发生CAUTI的相关因素包括导管留置时间、使用抗生素、PCT、IL-6、IL-8及IFN-γ水平(均P<0.05);多因素分析结果显示导管留置时长≥8 d、PCT≥3.98 ng/mL、IL-6≥15.42 pg/mL、IL-8≥116.34 pg/mL、IFN-γ≥26.63 ng/mL是泌尿外科患者发生CAUTI的独立危险因素,而使用抗生素是保护因素(均P<0.05)。结论PCT、IL-6、IL-8及IFN-γ水平与泌尿外科患者发生CAUTI呈正相关关系,在患者收治进泌尿外科期间及时对以上指标进行辅助检测,有利于尽早发现患者是否发生泌尿道感染,从而采取相应措施。

ObjectiveTo investigate the relationship between catheter-associated urinary tract infection(CAUTI)and serum levels of procalcitonin(PCT),interleukin-6(IL-6),interleukin-8(IL-8)and interferonγ(IFN-γ)in urology patients.MethodsFrom March 2019 to July 2020,135 patients were treated with catheter-assisted therapy in our hospital were selected and divided into control group(84 cases)and infection group(51 cases)according to the occurrence of related urinary tract infection.The serum levels of PCT,IL-6,IL-8 and IFN-γwere compared between the two groups;The correlation between PCT,IL-6,IL-8,IFN-γlevels and CAUTI in urology patients was analyzed.Receiver operating characteristic curve(ROC)was plotted to compare the diagnostic value of combined diagnosis for CAUTI in urology patients.Univariate analysis of the factors influencing CAUTI in urology patients.Binary logistic regression analysis of independent risk factors for CAUTI in urology patients.ResultsCompared with control group,the serum levels of PCT,IL-6,IL-8 and IFN-γin infected group were significantly increased(all P<0.05).Spearman correlation coefficient analysis showed that PCT,IL-6,IL-8 and IFN-γlevels were positively correlated with CAUTI in urological patients(all P<0.001).ROC curve showed that the area under the curve of combined diagnosis of four indexes was higher than that of combined diagnosis of two indexes(P<0.05).Univariate analysis showed that CAUTI was affected by catheter retention time,antibiotic use,PCT,IL-6,IL-8 and IFN-γlevels(all P<0.05).The results of multivariate analysis showed that catheter retention duration≥8 d,PCT≥3.98 ng/mL,IL-6≥15.42 pg/mL,IL-8≥116.34 pg/mL,IFN-γ≥26.63 ng/mL were independent risk factors for CAUTI in urological patients.The use of antibiotics was a protective factor(all P<0.05).ConclusionsThe changes of PCT,IL-6,IL-8 and IFN-γlevels are positively correlated with CAUTI in urology patients.Timely detection of these indicators during admission to urology is conducive to early detection of urinary tract infection in patients,so as to take appropriate measures,which has important clinical significance.