Abstract：Objective: To explore the changes and significance of serum endothelin-1 (ET-1), prostaglandin E2 (PGE2) and prostaglandin F2α (PGF2α) levels in patients before and after flexible ureteroscopic lithotripsy (FURL). Methods: A total of 268 patients with urinary calculi who were treated in the hospital from February 2017 to December 2019 were enrolled as the research subjects. All patients underwent FURL. The occurrence of systemic inflammatory response syndrome (SIRS) within 1 week after surgery, as well as levels of serum ET-1, PGE2 and PGF2α before and after surgery were observed. The relationship between serum ET-1, PGE2, PGF2α levels and the occurrence of SIRS was analyzed by univariate, multivariate and ROC curves analysis. Results: Among the 268 patients, there were 24 cases (8.96%) with SIRS (SIRS group) and 244 cases (91.04%) without SIRS (non-SIRS group) within 1 week after surgery. The difference of serum ET-1, PGE2, PGF2α before and after operation in SIRS group was higher than that in non-SIRS group (P<0.05). The results of univariate analysis showed that there were significant differences in gender, diabetes, operation time, postoperative levels of serum ET-1, PGE2 and PGF2α, and urinary tract infection between the two groups (P<0.05). The results of multivariate regression analysis showed that operation time not shorter than 120 min, urinary tract infection, postoperative ET-1 level not lower than 81.33 ng/L, PGE2 not lower than 254.23 pg/mL and PGF2α not lower than 117.56 ng/mL were independent predictors of SIRS. The results of ROC curve analysis showed that the area under the ROC curve (AUC) of serum ET-1 combined with PGE2 and PGF2α for predicting SIRS was higher than that of them alone (P<0.05). Conclusion: The levels of serum ET-1, PGE2 and PGF2α are increased in patients after FURL, which are highly expressed in patients with SIRS. The combined detection of three indexes is of application value in clinically predicting SIRS.
2021, Vol. 27 
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