鹤壁市人民医院 泌尿外科，河南 鹤壁 458030
Department of Urology, Hebi People's Hospital, Hebi, Henan 458030, China
目的 探讨血清炎症因子水平对经皮肾镜取石术（PCNL）后并发泌尿道感染的诊断价值。方法 选取2016年6月－2021年6月该院收治的120例行PCNL的患者作为研究对象，根据术后有无并发泌尿道感染，将其分为感染组（44例）和未感染组（76例）。比较两组患者术前、术后24 h血清炎症因子水平，并分析术后3项血清指标水平诊断PCNL术后并发泌尿道感染的效能。结果 两组患者术后24 h血清降钙素原（PCT）、白细胞介素-6（IL-6）和核因子κB（NF-κB）水平均较术前明显升高（P < 0.05），感染组术后24 h上述3项血清指标水平均高于未感染组（P < 0.05）；PCT、IL-6和NF-κB水平联合诊断PCNL术后并发泌尿道感染患者的灵敏度为90.91%，曲线下面积（AUC）为0.929，均高于单项血清指标诊断的灵敏度和AUC（P < 0.05），其特异度与单项血清指标诊断均相近（P > 0.05）。结论 泌尿道感染患者术后24 h血清炎症因子水平均较术前升高，且均对PCNL术后并发泌尿道感染具有一定的诊断效能，但三者联合诊断效能更高，可作为临床诊断的重要工具。
Objective To investigate the diagnostic values of serum inflammatory factors levels in urinary tract infection after percutaneous nephrolithotomy (PCNL).Methods 120 patients underwent PCNL were selected from June 2016 to June 2021 as the research object. They were divided into infection group (44 cases) and non infection group (76 cases) according to whether the patients were complicated with urinary tract infection after operation. The levels of serum inflammatory factors before and 24 h after operation were compared between the two groups, and the efficacy of the three serum indexes in diagnosing urinary tract infection after PCNL was analyzed.Results The serum PCT, IL-6 and NF-κB levels in the two groups 24 h after operation were significantly higher than those before operation (P < 0.05), and the levels of three serum indexes of infection group were higher than those of non infection group 24 h after operation (P < 0.05). The sensitivity and area under the curve (AUC) of combined diagnosis of serum PCT, IL-6 and NF-κB in patients with urinary tract infection after PCNL were 90.91% and 0.929 respectively, which were higher than those of single serum index diagnosis (P < 0.05), and the specificity was similar to that of single diagnosis (P > 0.05).Conclusion The levels of serum inflammatory factors in patients with urinary tract infection 24 h after operation were higher than those before operation, and all had a certain diagnostic efficacy for urinary tract infection after PCNL, but the combined diagnostic efficacy of the three serum indexes was higher, which can be used as an important tool for clinical diagnosis.