Abstract:Objective: To detect the serum procalcitonin (PCT) and C-reactive protein (CRP) /serum albumin (ALB) ratio in patients with upper urinary tract calculi before and after operation, and to analyze their relationships with perioperative infection. Methods: 180 patients with upper urinary tract calculi who underwent surgery in the Department of Urology of Zhongxiang People's Hospital from April 2017 to May 2019 were selected as the study subjects. According to whether infection occurred at admission, the patients were divided into infection group (n=100) and non-infection group (n=80). The infection group was further divided into significant infection group (n=60) and hidden infection group (n=40). Postoperative infection was divided into infection group (n=42) and non-infection group (n=138). Serum PCT, CRP and Alb levels were measured by automatic biochemical analyzer, and CRP/Alb ratio was calculated. Acute physiology and chronic health score system II (APACHE II) was calculated according to the related indicators and clinical characteristics of patients, White blood cell count (WBC) and red blood cell count (RBC) were measured, and the temperature (T), heart rate (HR) and respiratory rate (RR) were recorded. Results: The numbers of WBC, RBC and APACHE score in the patients with hospital infection were significantly higher than those in the patients without hospital infection (P < 0.05). One day after admission, the levels of serum PCT, CRP, CRP/Alb in the non-infected group were lower than those in the infected and occult infection group (P < 0.05), while the level of Alb was higher (P < 0.05) ; the levels of serum PCT, CRP and CRP/Alb in the occult infection group were lower than those in the infected group (P < 0.05). One day after operation, the levels of PCT, CRP and CRP/Alb in the infected group were significantly higher than those in the non-infected group (P < 0.05), while the level of ALB was lower (P < 0.05). One day after admission, the serum CRP level and CRP/Alb ratio of patients were detected separately, but the sensitivity was not high. The AUC of combined detection for predicting preoperative infection was 0.909, the corresponding sensitivity was 90.50%, and the specificity was 81.70%; One day after operation, the serum PCT level and CRP/Alb ratio were detected separately, which had a certain value in predicting preoperative infection. The combined detection of them predicted preoperative infection with AUC of 0.977, corresponding sensitivity of 92.90% and specificity of 98.60%. Conclusions: The serum PCT and CRP/Alb ratio are increased in patients with infection before and after operation, which may be used as biomarkers for perioperative infection of upper urinary tract stones.
董尚波, 黄江波. 血清PIC和CRP/ACB比值用于预测上尿路结石围手术期感染的应用价值[J]. 河北医学, 2020, 26(3): 407-410.
DONG Shangbo, et al. The Value of Serum PCT and CRP / ALB Ratio in the Prediction of Perioperative Infection of Upper Urinary Tract Calculi. HeBei Med, 2020, 26(3): 407-410.
[1] 杨超,姚俊,张双洋.上尿路结石患者行输尿管软镜钬激光碎石术后院内感染发生的相关因素分析[J].河北医学,2019,25(5):816~820. [2] 安立哲,黄晓波,许清泉,等.经皮肾镜碎石取石术后发生全身炎症反应综合征的多因素分析[J].中国微创外科杂志,2017,17(11):965~969. [3] 陈牡丹,陈健良,王金柱,等.C-反应蛋白与血清白蛋白比值预测感染性休克患者发生急性呼吸窘迫综合征的价值分析[J].中国急救医学,2018,38(2):164~168. [4] Arima K, Yamashita YI, Hashimoto D, et al. Clinical usefulness of postoperative C-reactive protein/albumin ratio in pancreatic ductal adenocarcinoma[J]. Am Surg, 2018, 216(1):111~115. [5] Venkataraman R, Gopichandran V, Ranganathan L, et al. Mortality prediction using acute physiology and chronic health evaluation II and acute physiology and chronic health evaluation IV scoring systems: is there a difference[J]. Indian J Crit Care Med, 2018, 22(5):332~335. [6] Ecke TH, Barski D, Weingart G, et al. Presentation of a method at the exploration stage according to IDEAL: percutaneous nephrolithotomy (PCNL) under local infiltrative anesthesia is a feasible and effective method - retrospective analysis of 439 patients[J]. Int Med Sci, 2017,14(4):302~309. [7] 朱越燕,张琦,王惠菊,等.上尿路结石微创术后发生尿脓毒症的防治策略研究进展[J].中华医院感染学杂志,2018,28(10):1450~1453. [8] Michel CS, Teschner D, Wagner EM, et al. Diagnostic value of sTREM-1, IL-8, PCT and CRP in febrile neutropenia after autologous stem cell transplantation[J]. Ann Hematol, 2017, 96(12):2095~2101. [9] Carannante N, Rossi M, Fraganza F, et al. A high PCT level correlates with disease severity in plasmodium falciparum malaria in children[J]. New Microbiol, 2017, 40(1):72~74. [10] 黄兰花,李少杰,邹莹.CRP/Alb比值对成人重症肺炎临床预后的评估价值[J].临床肺科杂志,2018,23(8):94~98. [11] 陈海玉,曾广志,唐召力,等.纤维支气管镜肺泡灌洗术治疗重症肺炎对患者全身炎症反应、呼吸力学指标的影响[J].中国医师杂志,2019,21(8):1251~1253. [12] 周敏杰,孙建,李梅芳,等.多发伤患者创伤早期血清降钙素原与脓毒症的关系[J].上海医学,2017,40(10):618~623.