High incidence of tuberculosis in prison officers in Zomba,Malawi

We conducted a study in four prisons in Zomba district, Malawi, to determine the tuberculosis case notification rate in prison officers during the year 2000. Of 201 prison staff, 9 (4.5%) were diagnosed with TB: 2 with smear-positive pulmonary tuberculosis (PTB), 4 with smear-negative PTB and 3 with extrapulmonary TB (EPTB). This incidence in prison officers (9/201) was significantly greater than the incidence in primary school teachers in a separate (unpublished) study in Malawi the previous year (78/4,289) (OR 2.58,[95% CI, 2.44 – 2.73], p <0.015). Expressed as annual TB case notification rates, the data for prison officers in these 4 prisons was 4,478 per 100,000, compared to 1,786 per 100,000 in teachers. There may be a high incidence of TB in prison officers. Further research needs to be carried out in this group to confirm these findings and to develop an occupational health service to reduce the risk of TB for these workers.     

结核病人外周血T辅助细胞含量分析

目的分析结核病患者Th细胞含量变化与结核分枝杆菌感染的关系。方法抽取肺结核患者、肺外结核患者、肺癌患者和健康人2ml肝素钠抗凝静脉血,按说明书进行胞内和膜表面分子染色,染色的细胞经流式细胞仪分析分泌IL-17、IFN-γ、IL-4阳性的T细胞和CTLA-4、PD-1阳性的T细胞。结果肺结核、肺外结核和肺癌组Th17细胞含量高于健康组、Th2细胞含量低于健康组、Th1细胞含量呈下降趋势,但与健康组比较差异无统计学意义。因此,肺结核、肺外结核组Th1细胞含量与Th17细胞含量比值及Th2细胞含量与Th17细胞含量比值低于健康组。肺外结核组CTLA-4阳性的CD3+T细胞(CTLA-4+CD3+T含量)含量高于肺结核组、肺癌组和健康组,肺结核和肺癌组PD-1阳性的CD4+T细胞(PD-1+CD4+T细胞)含量高于健康组。肺结核组,CTLA-4+CD3+T含量与Th1细胞含量呈负相关(r=-0.48,P=0.014);肺外结核组,PD-1+CD4+T细胞含量与Th17细胞含量呈正相关(r=0.68,P=0.015)。结论活动性结核病患者Th17细胞含量升高。     

Untreated Prior Pulmonary Tuberculosis Adversely Affects Pregnancy Outcomes in Infertile Women Undergoing in vitro Fertilization and Embryo Transfer: A Large Retrospective Cohort Study

Objective Prior pulmonary tuberculosis(PTB) on chest X-ray(CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer(IVF-ET). It was unclear whether untreated PTB would affect pregnancy outcomes after IVF-ET.Method We conducted a retrospective cohort study of 14,254 infertile patients who had received IVFET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth,clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.Results The untreated PTB group had significantly lower clinical pregnancy(31.7% vs. 38.1%) and live birth(23.8% vs. 30.6%) rates than the non-PTB group(both P < 0.001). Multivariate analysis revealed that untreated PTB was a risk factor for decreased live birth rate [odds ratio(OR), 0.80;95% confidence interval(CI), 0.66–0.98;P = 0.028] in all patients and for increased miscarriage(OR, 4.19;95% CI,1.69–10.39;P = 0.002) and decreased live birth(OR, 0.45;95% CI, 0.24–0.83;P = 0.011) rates in patients with unexplained infertility.Conclusions Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.     

Childhood tuberculosis in Malawi: caseload,diagnostic practices and treatment outcomes

There were 22,982 cases of TB registered in Malawi in 1998, of which 2739 (11.9%) were children. Children accounted for 11.3% of all case notifications with smear-positive pulmonary TB (PTB), 21.3% with smear-negative PTB and 15.9% with extrapulmonary TB (EPTB). A significantly higher proportion of TB cases were diagnosed in central hospitals. Only 45% of children completed treatment. There were high rates of death (17%), default (13%) and unknown treatment outcomes (21%). Treatment outcomes were worse in younger children and in children with smear-negative PTB. In 2001, all 44 non-private hospitals in Malawi that register and treat children with tuberculosis (TB) were surveyed to determine actual diagnostic practice. This cross sectional study identified 150 children aged 14 years or below in hospital receiving anti-TB treatment, 98 with pulmonary TB (PTB) and 52 with extrapulmonary TB (EPTB). Median duration of illness was 8 weeks. Most patients had fever, no response to anti-malarial treatment and antibiotics, and 40% had a positive family history of TB. Nearly 45% had weight for age < 60%. Diagnosis was mainly based on clinical features and radiography, with less than 10% having tuberculin skin tests or HIV serology, and very few having other sophisticated investigations. Diagnostic difficulties make it difficult to accurately define the actual burden of childhood TB in Malawi. Diagnostic practices are poor and treatment outcomes unsatisfactory.     

Delayed inpatient diagnosis and isolation of active pulmonary tuberculosis patients,a large tertiary care academic hospital experience in Riyadh,Saudi Arabia: What are we missing?

Objectives:To identify pulmonary tuberculosis (PTB) delayed inpatient diagnosis duration and contributing factors in an academic center in Saudi Arabia (SA).Methods:Retrospective review of all culture-confirmed PTB cases between May 2015 and April 2019. The outcomes were the timing between admission and suspicion of PTB or isolation to either early group (within 24 hours of admission) and late group (24 hours after admission).Results:Forty-nine cases were included with a median age of 49 years; a third of them were above 65 years of age. Most patients were of Saudi nationality and male. Approximately 38% of the cases were in the delayed group, half of them were smear-positive, with an average delay of 5.5 days. This was significant with age above 65 years (odds ratio [OR]=8.93, 95% confidence interval [CI]=2.22-35.95) presence of non-respiratory symptoms (OR=5.6, 95% CI=1.56-19.98), malignancy (OR=13.38, 95% CI=1.46-122.71), chronic medical problems (OR=4.90, 95% CI=1.31-18.32), missed chest x-ray findings (OR= 48, 95% CI=8.63-266.88) or procalcitonin level above 0.5 ng/mL (OR=12, 95% CI=1.58-91.08).Conclusion:Physicians in SA need to have a low threshold for PTB consideration in elderly patients or those with a history of malignancy. A careful review of the initial chest x-ray might help to overcome missing cases of PTB.     

新疆维吾尔族、汉族同型半胱氨酸与原发性高血压患者早期肾功能损害的相关性研究

目的 探讨维吾尔族和汉族原发性高血压(essential hypertension,EH)患者同型半胱氨酸(homocysteine,Hcy)与早期肾功能损害的相关性及民族差异性。 方法 收集2012年9月—2016年7月住院的EH患者812例。根据Hcy≥10 μmol/L分为H型高血压组(维吾尔族254例,汉族294例),Hcy<10 μmol/L为单纯高血压组(维吾尔族149例,汉族115例)。检测Hcy、肌酐等指标,分析Hcy与肾功能的关系并比较民族差异。 结果 维吾尔族、汉族同民族间H型高血压组与单纯高血压组比较,肌酐、胱抑素C水平及早期肾损害率均明显升高(P<0.05),eGFR明显下降(P<0.05)。H型高血压组和单纯高血压组中维吾尔族、汉族比较,eGFR和早期肾损害率差异无统计学意义(P>0.05)。Logistic回归分析显示,LnHcy (OR=2.201,95%CI:1.066～4.543,P=0.033)、胱抑素C (OR=1.475,95%CI:1.303～1.699,P<0.001)、低高密度脂蛋白胆固醇(OR=2.475,95%CI:1.436～4.268,P=0.001)、血尿素氮(OR=1.277,95%CI:1.054～1.547,P=0.013)是维吾尔族EH患者早期肾功能损害的独立危险因素;LnHcy (OR=3.804,95%CI:1.855～7.798,P<0.001)、胱抑素C (OR=1.655,95%CI:1.433～1.911,P<0.001)、低高密度脂蛋白胆固醇(OR=2.059,95%CI:1.208～3.509,P=0.008)、血尿素氮(OR=1.222,95%CI:1.018～1.468,P=0.032)、吸烟(OR=1.993,95%CI:1.082～3.671,P=0.027)是汉族EH患者早期肾功能损害的独立危险因素。 结论 Hcy是维吾尔族和汉族原发性高血压患者早期肾功能损害的共同危险因素,原发性高血压患者早期肾损害率在两民族间无差异。      

湖南湘潭县农村居民耐多药结核病危险因素病例对照研究

目的探讨湘潭县农村居民耐多药结核病患病的危险因素,为农村耐多药结核病防治提供依据。方法采用1∶1配对病例对照研究方法,在湘潭县"结核病信息管理系统"中抽取耐多药结核病与非耐多药结核病(泛耐药患者除外)的农村居民患者各76名进行入户问卷调查,采用条件logistic回归分析耐多药结核病患病的危险因素。结果单因素分析显示,患者家庭总收入低、低体重(BMI18.5)、文化水平低、结核病接触史、既往不规则结核病治疗史、复治等方面的差异有统计学意义(P0.05);多因素条件logistic回归分析显示,家庭总收入低、结核病接触史、既往不规则结核病治疗史是结核病患者产生耐多药的主要危险因素OR及95%CI分别为1.667(1.105~2.391)、3.471(2.230~5.314)、4.836(3.119~7.538)。结论需采取针对性的措施提高结核病患者治疗依从性,并对家庭困难的结核病患者提供更多的政策支持。     

MBL2基因P57位点多态性与结核易感性关系的Meta分析

目的系统评价甘露糖结合凝集素2(mannose-binding lectin 2,MBL2)基因P57位点多态性与结核易感性的相关性。方法检索Pub Med、CNKI、Wan Fang Data、CBM、EMbase、VIP等数据库,检索时限为建库至2016年6月20日。查找所有研究MBL2基因P57位点多态性与结核易感性关系的相关文献,采用Rev Man 5.3软件进行Meta分析。结果共纳入8篇英文文献,均为病例对照研究,结核组共1 375例,对照组共1 465例。经异质性检验,各研究之间不存在统计学异质性(P≥0.1),故总体分析采用固定效应模型。Meta分析结果显示:在总体人群中,MBL2基因P57位点与结核易感性关联无统计学意义(CC+AC vs AA:OR=0.84,95%CI:0.68~1.04,P0.05)。亚组分析结果显示:在亚洲人群中,MBL2基因P57位点多态性与结核易感性关联无统计学意义(CC+AC vs AA:OR=1.46,95%CI:0.82~2.60,P0.05);在高加索人群中关联也无统计学意义(CC+AC vs AA:OR=0.80,95%CI:0.33~1.92,P0.05);在非洲人群中,MBL2基因P57位点多态性可能降低结核易感性,结果有统计学意义(CC+AC vs AA:OR=0.77,95%CI:0.61~0.97,P0.05)。结论MBL2基因P57位点多态性可能降低非洲人群结核发病风险,与亚洲人群和高加索人群结核的发病风险可能不存在相关性,但该研究样本量较小,需扩大样本量进一步确认。     

吸烟、饮酒与肺结核危险因素的配对病例—对照研究

目的 探讨吸烟、饮酒对成都地区成人肺结核发病危险的影响。进一步确定成人肺结核发病的危险因素。方法 有杉社区病例-对照研究的方法。随意选择社区健康对照174人,按年龄、性别、居住社区与同年收集到的174例成人新发肺结核进行配对,采用问卷面对面调查个人嗜好（吸、饮酒）,并在设计中严格控制偏倚,利用Logistic多元回归分析法,排队多种混杂因素（如结核接触史,社会经济地位,BCG接种史,环境因素,体重指数等）,以确定吸烟煤、饮酒与肺结核发病的危险关系。结果 单因素分析时本研究病例主动吸烟（OR=2.12,P=0.006)、被动吸烟（OR=1.55,P=0.04）、不同烟种（OR=1.31,P=0.005)和饮酒（OR=1.81,P=0.008)等变量在编译学上与肺结核发病有明显的相关性,进一步多元回归分析则显示,上述各单因素与肺结核发病之间无相关性,只有当吸烟者同时又是饮酒者时,两者的交隔绝作用方显示出与肺结核有密切关系（OR=7.729,P=0.013,95%C.I.=1.5215-39.2634),并同时存在明显的剂量-效应关系。即病例组每吸一支烟,同时又饮酒时发生肺结核的危险性较对照1.73倍（P=0。0002,95%C.L.I.=1.300-2.3028)。结论 单纯吸烟或饮酒与肺结核的发病无关,而吸烟同时又饮酒时则是成都地区成人患肺结核的危险因素。     

急性脑出血患者院内感染相关因素分析

目的:探讨急性脑出血患者院内感染的发生率及导致急性脑出血患者发生院内感染的相关因素,为防治急性脑出血患者院内感染提供理论依据。方法:对我院神经内科自2011年1～12月收治的246例急性脑出血患者进行回顾性分析,调查急性脑出血患者院内感染的发生率及导致其发生院内感染的相关因素,进一步分析院内感染与急性脑出血患者预后的关系。结果:246例急性脑出血发生院内感染57例,发生率为23.2%。单因素分析发现,患者的年龄、GCS评分、吸烟史、糖尿病史、慢性支气管炎、低蛋白血症、院内侵袭性操作及呼吸机使用是脑出血患者院内感染发生的危险因素,差异有统计学意义。多因素分析发现,吸烟史、糖尿病史、慢性支气管炎、低蛋白血症及入院时GCS评分是影响脑出血患者发生院内感染的独立危险因素;院内感染和GCS评分是影响脑出血患者预后的独立危险因素。结论:脑出血患者院内感染发生率高,且是影响脑出血患者预后的独立危险因素。     

重庆市复治涂阳肺结核患者耐药分析

目的 通过了解重庆市复治涂阳肺结核患者对抗结核药物的耐药情况,为改进重庆市肺结核病的防治措施提供参考和建议。方法 收集重庆市39个区县2016年5月至2017年10月期间复治涂阳患者培养阳性的菌株,并采用对硝基苯甲酸培养法鉴定结核分枝杆菌复合群。共收集428例复治涂阳肺结核患者菌株,采用传统的比例法进行8种抗结核药物的药敏试验,并对复治涂阳肺结核患者菌株耐（多）药情况进行分析。8种抗结核药物包括：异烟肼（INH）、利福平（RFP）、链霉素（Sm）、乙胺丁醇（EMB）、氧氟沙星（Ofx）、卡那霉素（Km）,阿米卡星（Am）和卷曲霉素（Cm）。结果 纳入的428例复治肺结核患者总耐药率为45.09%,以青年组耐药率最高,达57.14%,显著高于老年组（36.59%,P=0.002<0.017),但与中年组比较差异无统计学意义（43.52% P=0.022(>)0.017）;复治肺结核患者耐多药率为27.10%,其中青年组耐多药率（41.96%）显著高于中年组（24.35%）和老年组（17.89%, P<0.05);复治肺结核患者广泛耐药率达3.74%,耐Ofx及耐任一种二线注射类抗结核药物（包括Km、Am和Cm）的比例分别为16.12%和6.31%;复治肺结核患者对4种一线抗结核药物的耐药率顺位为：利福平（33.18%）、异烟肼（32.94%）、链霉素（28.74%）、乙胺丁醇（9.11%）。复治涂阳肺结核患者耐一种抗结核药物的耐药率为10.28%,对8种抗结核药物全部耐药的比例为1.17%。复治涂阳肺结核患者耐药状况不同性别之间差异无统计学意义。结论 重庆市复治涂阳肺结核患者的耐药形势严峻,其中青年是耐多药结核病发生的危险人群,应根据本市情况制定科学合理的结核病防治方案,减少耐药结核病的产生和传播。     

急性心肌梗死患者院前延迟影响因素的系统评价及防控对策

目的 探讨急性心肌梗死患者院前延迟的影响因素,并明确应对策略,旨在缩短院前延迟时间。 方法 经Pubmed、Embase等十大数据库检索相关文献,用NOS量表评价纳入文献19篇,均为流行病调查研究,以Rev Man 5.3软件进行统计分析。 结果 通过Meta分析将影响因素归纳为3大类。①社会因素:年龄[OR=1.090,95%CI(1.060～1.130),P＜0.001]、性别[OR=1.180,95%CI(1.050～1.330),P=0.006]、文化水平[OR=1.410,95%CI(1.190～1.670),P＜0.001]、居住地区[OR=1.350,95%CI(0.990～1.840),P=0.060];②临床因素:糖尿病史[OR=1.380,95%CI(1.220～1.560),P＜0.001]、心绞痛史[OR=1.370,95%CI=1.050～1.770,P=0.020]、心肌梗死史[OR=1.080,95%CI(0.640～1.830),P=0.760]、PCI史[OR=0.760,95%CI(0.670～0.860),P＜0.001];③其他因素: 夜间发病[OR=1.630,95%CI(1.340～1.970),P＜0.001]、就诊方式[OR=0.640,95%CI(0.570～0.710),P＜0.001]、未将症状归因于心脏[OR=3.100,95%CI(1.620～5.940),P＜0.001]。 结论 高龄、女性、糖尿病史、心绞痛史、夜间发病、未将症状归因于心脏是其危险因素,高学历、PCI史、EMS就诊是其保护因素,居住地区、心肌梗死史与急性心肌梗死患者院前延迟无关。采取切实有效地干预措施,能够缩短院前延迟时间,降低患者院外死亡率。      

少数民族地区肺结核患者就诊延迟状况及其影响因素分析

目的 探讨少数民族地区肺结核患者就诊延迟情况及其影响因素,为制订有效防控措施提供参考依据.方法 从全国结核病信息管理系统中收集锦屏县2010-2014年确诊的1 166例肺结核患者病历资料,分析患者就诊延迟相关情况,采用Logistic回归模型分析患者就诊延迟影响因素.结果 2010-2014年锦屏县报告的1 166例肺结核患者中,就诊延迟568例,就诊延迟率为48.71％(568/1 166),就诊延迟时间大于或等于30 d者为67.25％(382/568),≥183 d(半年)者为6.51％(37/568),≥365 d者为2.64％(15/568),就诊延迟最长时间达7年(2 549 d);多因素Logistic回归分析结果表明,与非农民、痰阴、非重症患者比较,农民(OR=1.867,95％ CI:1.300～2.700)、痰阳(OR=1.631,95％ CI:1.200～2.100)、重症患者(OR=0.684,95％ CI:0.500～0.900)是少数民族地区肺结核患者就诊延迟的危险因素.结论 少数民族地区肺结核患者就诊延迟与民族差异无关,患者职业农民、痰检阳性与是否重症是少数民族地区肺结核患者就诊延迟的影响因素.     

A prospective longitudinal study evaluating a T-cell-based assay for latent tuberculosis infection in health-care workers in a general hospital in Beijing

Background The health-care workers (HCWs) are at high risk of acquiring infection with Mycobacterium tuberculosis.The objectives of this study were to compare the performance of the T-SPOT.TB and tuber...     

Diagnosis of pulmonary tuberculosis among asymptomatic HIV+ patients in Guangxi, China

Background Pulmonary tuberculosis （PTB） among asymptomatic Chinese patients with HIV infection has not been investigated despite high tuberculosis burden in China. This study was aimed to evaluate the prevalence, risk factors and clinical outcomes of PTB among asymptomatic patients with HIV/AIDS in Guangxi to facilitate the development of diagnostic and treatment strategies.Methods All asymptomatic adult HIV-infected patients with CD4 ＜350 cells/μl who attended four HIV clinics in Guangxi between August 2006 and March 2008 were evaluated for active PTB with physical examination, chest X-ray （CXR）,sputum smear and/or sputum liquid culture. Data were described using median （interquartile range, IQR） and frequencies.Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with PTB.Results Among 340 asymptomatic subjects, 15 （4%） were diagnosed with PTB, with 4 （27%） sputum smear positive and 8 （53%） sputum culture positive. CXR has higher diagnostic sensitivity （87%） than sputum smear （25%） and sputum culture （67%）, but lower specificity （56%） compared with sputum smear （99%） and culture （100%）. In univariate analysis,injection drug user, body mass index （BMI） ＜18 kg/m2, CD4 ＜50 cells/μl and presence of peripheral lymphadenopathy were associated with an increased risk of asymptomatic PTB, while in multivariate analysis only peripheral lymphadenopathy maintained statistical significance （OR=7.6, 95% CI 1.4-40）. Patients with negative smear and minor or no abnormalities on CXR had longer interval between screening and TB treatment.Conclusions PTB was relatively common in this group of HIV＋ asymptomatic Chinese patients. Diagnosis is challenging especially where sputum culture is unavailable. These findings suggest that an enhanced evaluation for PTB needs to be integrated with HIV care in China and transmission prevention in China to control at both households and health care facilities, especially for patients with factors associated with a higher risk of PTB.     

CORRELATION BETWEEN FIBRINOGEN LEVEL AND CEREBRAL INFARCTION

FIBRINOGEN,a340-kDa protein synthesized inthe liver,is the precursor of fibrin and an acutephase reactant.As an important factor of thethrombotic waterfall and marker of inflammation,fibrino-gen was believed to be correlated with thromboembolic dis-ease.1…     

健康相关行为与肺结核发病的病例对照研究

目的探讨健康相关性行为与肺结核发病的关系,揭示肺结核危险因素。方法采用病例对照设计,应用自行设计的问卷调查济宁市136例肺结核病例和149例对照的健康相关行为及其它肺结核潜在危险因素情况,并进行单因素和多因素条件Logistic回归分析。结果多因素条件Logistic回归分析显示,接种卡介苗（OR=O．168,OR95％CI：0．086—0．327,P=0．000）是肺结核发病的保护性因素,结核病人接触史（OR=2．405,OR95％CI：1．113～5．200,P=0．026）、心理健康程度低（DR=1．983,0R95％CI：1．277～3．080,P=0．002）、吸烟（OR=6．282,0R95％CI：3．188～12．382,P=0．000）和已戒烟（OR=9．938,OR95％CI：2．851～34。634,P=0．000）是肺结核危险因素。结论接种卡介苗能够有效预防肺结核,而接触结核病人、吸烟以及心理健康程度低都是肺结核发病的危险因素。     

海南省92例肺结核耐药的危险因素分析

目的 探讨海南省92例肺结核发生耐药的相关危险因素。方法 收集海南省92例耐药的肺结核患者(耐药组)和120例非耐药的肺结核患者(非耐药组)的临床资料(性别、年龄、居住地、初/复治、治疗过程是否中断、结核病诊断治疗史、第一次是否在结核病定点医疗机构就诊)进行统计学处理,把有统计学意义的因素进行多因素非条件Logisitic回归分析,探讨肺结核发生耐药的相关危险因素。结果 肺结核耐药的发生与患者的性别、年龄无关(P>0.05),与居住地、初/复治、治疗过程是否中断、有结核病诊断治疗史,第一次在非结核医疗定点机构就诊有关(P<0.01);多因素非条件Logisitic回归分析显示,居住地为农村(OR=2.467 95%CI=1.309~4.650)、复治(OR=4.046 95%CI=2.274~7.199)、治疗过程曾经中断(OR=5.195 95%CI=2.877~9.381)、有结核病诊断治疗史(OR= 7.792 95%CI=4.206~14.436)和第一次在非结核医疗定点机构就诊(OR=5.495 95%CI=3.038~9.938)是产生耐多药结核病的危险因素。结论 居住地为农村、复治、曾经中断治疗、有结核病诊断治疗史、第一次在非结核病定点医疗机构就诊的肺结核患者易出现耐药性。     

泌尿系结石日间手术患者延迟出院的危险因素分析

  目的  探讨泌尿系结石日间手术患者延迟出院的危险因素。  方法  回顾性分析广州医科大学附属第一医院泌尿外科2019年1—12月泌尿系结石日间手术的749名患者的电子病历资料,根据患者出院时间将其分为延迟出院组(71例)和正常出院组(678例),对2组患者的一般资料、术后1 h生命体征和常见血液学指标等进行比较,用logistic回归分析研究患者术后延迟出院的危险因素。  结果  泌尿系结石日间手术患者延迟出院的发生率为9.5%。Logistic回归分析显示年龄(OR=3.209,95% CI:1.621~6.352,P=0.001)、PCNL治疗(OR=2.212,95% CI:1.290~3.793,P=0.004)、体温(OR=4.363,95% CI:1.967~9.682,P < 0.001)、中性粒细胞比率(neutrophil ratio,NEUT;OR=1.973,95% CI:1.156~3.370,P=0.013)、血红蛋白(hemoglobin,Hb;OR=2.776,95% CI:1.170~6.582,P=0.020)和血清钾(serum potassium,K+;OR=2.680,95% CI:1.162~6.177,P=0.021)是患者延迟出院的独立危险因素。  结论  高龄、行PCNL、术后1 h体温＞38 ℃、NEUT＞70%、Hb＜90 g/L和低血钾的日间手术患者延迟出院风险增加,医护人员应重点关注并及时应对,以减少日间手术风险,提高其质量和安全性。