發(fā)布時間：2016-11-11 07:53

【摘要】 目的 探討輸尿管鏡碎石術(shù)后并發(fā)感染及非感染患者的血清降鈣素原（PCT）、C反應(yīng)蛋白的變化及其臨床意義。方法 回顧性分析我院泌尿外科2011年7月至2013年9月收治的400例輸尿管結(jié)石行輸尿管鏡碎石術(shù)患者的臨床資料，術(shù)后即對患者進(jìn)行PCT、CRP、監(jiān)測，根據(jù)PCT、CRP陽性判定的感染患者與最后確診情況結(jié)果（體溫升高（≧37.5℃）、WBC（>10×109g/L）結(jié)合細(xì)菌培養(yǎng)確診）進(jìn)行比較；并根據(jù)確診結(jié)果將患者分為感染組（63例）、非感染組（337例）比較兩組患者的PCT、CRP等指標(biāo)情況。結(jié)果 臨床和實(shí)驗(yàn)室最后確診術(shù)后感染患者63例，PCT早期判定感染患者82例，診斷的靈敏度=82.54%，特異度=91.10%，漏診率=17.46%，誤診率=8.9%。CRP早期判定感染患者181例，診斷的靈敏度60.32%，特異度=57.57%，漏診率=39.68%，誤診率=42.43%；PCT的AUC值=0.901，CRP的AUC值=0.711；PCT與WBC呈顯著的正相關(guān)（r=0.431，p=0.000<0.05）；CRP與WBC也呈顯著的正相關(guān)（r=0.317，p=0.005）。結(jié)論 輸尿管鏡碎石術(shù)后患者并發(fā)感染與PCT、CRP具有一定的相關(guān)性，PCT、CRP可以作為術(shù)后并發(fā)感染早期的一種判斷指標(biāo)。
【關(guān)鍵詞】輸尿管鏡；碎石術(shù)；并發(fā)感染；血清降鈣素原；C反應(yīng)蛋白

Clinic significance of serum procalcitonin and C reactive proteinmonitoring in after ureteroscopic lithotripsy
【Abstract】Objective Ureteroscopic lithotripsy for serum concurrent infection and non infectionpatients procalcitonin (PCT), C reactive protein and its clinical significance.Methods Retrospective analysis of our hospital from 2011 July to 2013 Septemberin Department of urology were treated 400 cases of ureteral calculiureteroscopic lithotripsy in patients with clinical data, postoperative PCT,CRP of patients, monitoring, according to the infection in patients with the final diagnosis result of PCT, CRP positive judgment (elevated body temperature (≥ 37.5 ℃), WBC (>10 * 109g/L) combined with bacterialculture confirmed) were compared; and the patients were divided intoinfection group according to the diagnosis (63 cases), non infection group(337 cases) were compared between the two groups PCT, CRP and other indicators.Results In 63 patients with final diagnosis of postoperative infection of clinical and laboratory, PCT early diagnosis of infection in patients with 82 cases, the sensitivity of =82.54% diagnosis, specificity of =91.10% =17.46%, the rate of missed diagnosis, misdiagnosis rate was =8.9%. Early diagnosis of 181 patients with CRP infection, 60.32% diagnosis sensitivity, specificity of =57.57% =39.68%, the rate of missed diagnosis, misdiagnosis rate=42.43%; PCT AUC =0.901, CRP AUC =0.711; positively correlated withPCT and WBC (r=0.431, p=0.000<0.05); CRP and WBC also had positive relationship (r=0.317, p=0.005).ConclusioAfter ureteroscopic lithotripsy in patients with concurrent infection with PCT, CRP has some relevance, PCT, CRP can be used as a judgment index of early postoperative infection after operation.
【Key words】Ureteroscopy; lithotripsy; infection; serum procalcitonin; C reactive protein

輸尿管鏡碎石術(shù)是治療輸尿管結(jié)石的重要手段，主要適用于輸尿管中下段結(jié)石、結(jié)石周圍被輸尿管息肉包裹等情況，由于輸尿管存在生理性狹窄，，而且管徑比較細(xì)，采用輸尿管鏡進(jìn)行碎石容易出現(xiàn)感染等多種并發(fā)癥。及時準(zhǔn)確的預(yù)測感染并給予合理的抗感染治療，對于改善患者的預(yù)后具有重要作用。血清降鈣素原（Procalcitonin,PCT)和急性期反應(yīng)蛋白（Acute phase response proteins ,CRP)作為一個新的診斷細(xì)菌性感染的細(xì)胞因子指標(biāo)，在感染性疾病的診斷中得到廣泛重視，在本研究中檢測了輸尿管碎石術(shù)后感染患者和非感染患者的血清PCT和CRP水平，探討二者在監(jiān)測術(shù)后患者感染中的作用。

1、資料與方法
1.1一般資料
1.2方法
1.3 觀測指標(biāo) 
1.4統(tǒng)計方法
2結(jié)果
2.1PCT、CRP監(jiān)測判定的感染結(jié)果與最后確診的感染結(jié)果情況
2.2確診的感染組和非感染組相關(guān)指標(biāo)的比較
2.3術(shù)后感染患者的PCT、CRP與WBC的相關(guān)性分析
3 討論
4 參考文獻(xiàn)

本文編號：170525