摘要
目的探讨血清可溶性髓系细胞触发受体1(sTREM-1)、可溶性血红蛋白清道夫受体163蛋白(sCD163)水平对良性前列腺增生(BPH)患者术后尿源性感染的评估价值。方法回顾性队列研究,选取2020年7月至2023年7月在延安市中医医院行经尿道前列腺电切术治疗的102例BPH患者作为研究对象,根据术后是否发生尿源性感染分为感染组(23例)和未感染组(79例)。感染组年龄60~76(67.37±4.53)岁;未感染组年龄60~78(67.87±4.42)岁。对比两组患者术后7 d的血清sTREM-1、sCD163水平,分析患者血清sTREM-1、sCD163水平检测诊断尿源性感染的评估价值,单因素及多因素logistic回归分析BPH患者发生尿源性感染的影响因素。采用t检验、χ^(2)检验。结果感染组血清sTREM-1、sCD163水平均高于未感染组[(76.47±8.29)ng/L比(52.65±6.91)ng/L、(71.25±6.64)μg/L比(49.26±5.37)μg/L],差异均有统计学意义(t=13.893、16.358,均P<0.05)。血清sTREM-1、sCD163水平评估BPH患者术后尿源性感染的曲线下面积(AUC)分别为0.734(95%CI 0.684~0.779)、0.842(95%CI 0.798~0.887),两者联合评估的AUC为0.904(95%CI 0.854~0.956)。两组患者年龄、体质量指数、合并高血压病、合并糖尿病、吸烟史、饮酒史、血尿酸、三酰甘油、总胆固醇比较,差异均无统计学意义(均P>0.05);感染组手术时间、术后住院时间、留置导尿管时间均长于未感染组[(73.21±6.14)min比(69.39±6.93)min、(7.29±1.29)d比(6.46±1.67)d、(4.24±0.92)d比(3.75±0.84)d],降钙素原(PCT)、C-反应蛋白(CRP)水平均高于未感染组[(2.37±0.45)μg/L比(1.43±0.57)μg/L、(36.06±6.54)mg/L比(26.23±5.34)mg/L],差异均有统计学意义(t=2.384、2.197、2.410、7.268、7.374,均P<0.05)。logistic回归分析结果显示,PCT(OR=2.088,95%CI 1.436~3.035)、CRP(OR=2.309,95%CI 1.536~3.472)、血清sTREM-1(OR=3.047,95%CI 1.859~4.992)、sCD163(OR=2.617,95%CI 1.690~4.051)是尿源性感染的相关因素(均P<0.05)。结论BPH术后尿源性感染患者血清sTREM-1、sCD163水平均呈高表达,二者与BPH术后尿源性感染存在一定关系,是患者术后发生尿源性感染的危险因素,sTREM-1+sCD163检测对术后发生尿源性感染的评估价值较高。
Objective To explore the value of serum levels of soluble myeloid trigger receptor 1(sTREM-1)and soluble hemoglobin sCD163(sCD163)in the evaluation of postoperative urinaryinfection in patients with benign prostatic hyperplasia(BHP).Methods A total of 102 patients with BHP who underwent transurethral resection of prostate in Yan'an Hospital of Traditional Chinese Medicine from July 2020 to July 2023 were selected,and divided into an infected group(23 cases)and uninfected group(79 cases)according to whether they had postoperative urinary infection.The serum levels of sTREM-1 and sCD163 were compared between the two groups 7 days after the operation.The value of serum sTREM-1 and sCD163 in the evaluation of postoperative urinary infection in the patients was analyzed.The influencing factors of postoperative urinary infection in the patients were explored by the univariate analysis and multivariate logistic regression analysis.t andχ^(2) tests were applied.Results The levels of sTREM-1 and sCD163 in the infected group were higher than those in the uninfected group[(76.47±8.29)ng/L vs.(52.65±6.91)ng/L and(71.25±6.64)μg/L vs.(49.26±5.37)μg/L],with statistical differences(t=13.893 and 16.358;both P<0.05).The areas under the curves(AUC)of sTREM-1,sCD163,and the combination of the two for postoperative urinary infection in the patients were 0.734(95%CI 0.684-0.779),0.842(95%CI 0.798~0.887),and 0.904(95%CI 0.854-0.956),respectively.There were no statistical differences in age,body mass index,complication with hypertension,complication with diabetes mellitus,smoking history,drinking history,uric acid,triacylglycerol,and total cholesterol between the two groups(P>0.05).The operation time,postoperative hospitalization time,and catheter indwelling time in the infected group were longer than those in the uninfected group[(73.21±6.14)min vs.(69.39±6.93)min,(7.29±1.29)d vs.(6.46±1.67)d,and(4.24±0.92)d vs.(3.75±0.84)d],and the levels of procalcitonin(PCT)and C-reactive protein(CRP)in the infected group were higher than those in the uninfected group[(2.37±0.45)μg/L vs.(1.43±0.57)μg/L and(36.06±6.54)mg/L vs.(26.23±5.34)mg/L],with statistical differences(t=2.384,2.197,2.410,7.268,and 7.374;all P<0.05).The results of logistic regression analysis showed that PCT(OR=2.088,95%CI 1.436-3.035),CRP(OR=2.309,95%CI 1.536-3.472),serum sTREM-1(OR=3.047,95%CI 1.859-4.992),and serum sCD163(OR=2.617,95%CI 1.690-4.051)were risk factors for postoperative urinary infection in the patients(P<0.05).Conclusion Serum sTREM-1 and sCD163 are highly expressed in patients with postoperative urinary infection after BPH surgery,and are risk factors for postoperative urinary infection.The combined detection of STREM-1 and SCD163 is of higher value in the evaluation of postoperative urinary infection.
作者
拓鹏飞
王帅帅
邹涛
宗有龙
Tuo Pengfei;Wang Shuaishuai;Zou Tao;Zong Youong(Department of Urological Surgery,Yan'an Hospital of Traditional Chinese Medicine,Yan'an 716000,China;Department of Urological Surgery,Second Hospital,Xi'an Jiaotong University,Xi'an 710004,China)
出处
《国际医药卫生导报》
2024年第9期1526-1531,共6页
International Medicine and Health Guidance News
基金
陕西省重点研发计划(2019ZDX-SF-069)。
