本文選題：尿膿毒血癥　切入點(diǎn)：降鈣素原　出處：《山東醫(yī)藥》2016年04期

【摘要】：目的探討血清降鈣素原(PCT)對(duì)經(jīng)皮腎鏡碎石術(shù)后尿膿毒血癥的早期診斷價(jià)值。方法回顧性分析185例因上尿路結(jié)石并泌尿道感染行經(jīng)皮腎鏡碎石術(shù)患者臨床資料。其中術(shù)后并發(fā)尿膿毒血癥(觀察組)94例,術(shù)后未并發(fā)尿膿毒血癥(對(duì)照組)91例。檢測(cè)兩組術(shù)前及術(shù)后24 h血清PCT、CRP和WBC計(jì)數(shù)。受試工作特征曲線(ROC)評(píng)價(jià)血清PCT對(duì)經(jīng)皮腎鏡碎石術(shù)后尿膿毒血癥的早期診斷價(jià)值。結(jié)果兩組術(shù)前血清PCT、WBC計(jì)數(shù)比較P均0.05,CRP比較P0.05;與術(shù)前比較,觀察組術(shù)后24 h血清PCT水平升高(P0.05),CRP、WBC計(jì)數(shù)差異無統(tǒng)計(jì)學(xué)意義(P均0.05)。血清PCT診斷經(jīng)皮腎鏡碎石術(shù)后尿膿毒血癥的ROC曲線下面積為0.872(95%CI:0.632~0.975);血清PCT診斷尿膿毒血癥的敏感度為90.24%,特異度為82.57%,陽性預(yù)測(cè)值為81.35%,陰性預(yù)測(cè)值為88.37%。結(jié)論血清PCT可作為早期診斷經(jīng)皮腎鏡碎石術(shù)后尿膿毒血癥的可靠預(yù)測(cè)指標(biāo)。
[Abstract]:Objective to investigate the value of serum procalcitonin (PCT) in the early diagnosis of urinary sepsis after percutaneous nephrolithotripsy. Methods the clinical data of 185 patients with upper urinary calculi and urinary tract infection underwent percutaneous nephrolithotripsy were retrospectively analyzed. There were 94 cases of urinary sepsis in the observation group. There were 91 cases of urinary sepsis after operation (control group, 91 cases). Before and 24 hours after operation, the levels of serum PCT CRP and WBC were measured in both groups. The value of serum PCT in the early diagnosis of urinary sepsis after percutaneous nephrolithotripsy was evaluated. Results the WBC count of serum PCT in both groups was higher than that before operation (P < 0.05) and CRP was higher than that before operation (P < 0.05), and compared with that before operation (P < 0.05). There was no significant difference in serum PCT count between two groups 24 hours after operation. The area under ROC curve of serum PCT for diagnosis of urinary sepsis after percutaneous nephrolithotripsy was 0.87295 CI: 0.632and the sensitivity of serum PCT in the diagnosis of urinary sepsis was as follows: the sensitivity of serum PCT in the diagnosis of urinal sepsis was 0.87 2%, 0.62% and 0.975% respectively, and the sensitivity of serum PCT in the diagnosis of urinary sepsis was higher than that in control group (P < 0.05). 90.24, the specificity was 82.57, the positive predictive value was 81.35, the negative predictive value was 88.37. Conclusion Serum PCT can be used as a reliable predictor for early diagnosis of urinary sepsis after percutaneous nephrolithotripsy.
【作者單位】： 瀘州醫(yī)學(xué)院附屬醫(yī)院;
【基金】：四川省科學(xué)技術(shù)廳基金項(xiàng)目(14JC0801) 瀘州市科研基金項(xiàng)目(2013LZLY-J26)
【分類號(hào)】：R699

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