血浆降钙素原对于复杂性上尿路感染导致尿脓毒血症的预警作用研究

目的:探讨血浆降钙素原(PCT)水平变化在复杂性上尿路感染患者病情进展为尿脓毒血症的预警作用。方法:回顾性分析我院2012年1月~2013年11月收治的98例上尿路结石合并复杂性上尿路感染患者,患者均接受上尿路结石手术治疗,并分别在手术治疗前及术后第1天测定血浆PCT及C反应蛋白(CRP)。参照2011版《中国泌尿外科疾病诊断治疗指南》对接受手术治疗后出现临床细菌感染症状并伴发全身炎症反应综合征(SIRS)的患者诊断为尿脓毒血症,按照患者在手术治疗后是否并发尿脓毒血症分为观察组和对照组,对观察组和对照组患者的血浆PCT水平差异进行统计学分析处理。结果:纳入本研究共98例患者中,手术治疗后并发尿脓毒血症(观察组)共48例,手术治疗后未并发尿脓毒血症(对照组)共50例,经过对两组患者不同阶段血浆PCT水平及C反应蛋白水平的差异进行统计学分析,两组间手术治疗前血浆PCT水平差异无统计学意义(P0.05),术后第1天两组血浆PCT水平较术前均升高,观察组术后第1天血浆PCT水平较术前明显升高,差异具有统计学意义(P0.05),对照组术后第1天血浆PCT水平较术前升高,统计显示差异具有统计学意义(P0.05),两组术后第1天血浆PCT水平比较,差异具有统计学意义(P0.01)。结论:上尿路结石合并复杂性上尿路感染患者在接受手术治疗后,测定术后第1天血浆PCT水平可作为是否会并发尿脓毒血症的预警指标。

The study of plasma procalcitonin as an early warning sign for urinary sepsis caused by complex urinary tract infection

Objective：To approach the effectiveness of plasma procalcitonin（PCT）as an early warning sign for urinary sepsis caused by complex urinary tract infection.Method：A retrospective analysis of 98inpatients with complex upper urinary tract infection complicated by upper urinary tract calculi in the Department of Urology,the Affiliated Hospital of Qingdao University from January 2012to November 2013.All cases accepted surgical treatment for upper urinary tract calculi.And the preoperative and postoperative plasma PCT and c-reactive protein（CRP）level were respectively tested.According to the 2011edition Chinese Guidelines of the diagnosis and treatment of urological diseases,the patients diagnosed as urinary sepsis should have clinical symptoms of bacterial infections associated with systemic inflammatory response syndrome（SIRS）.98cases were divided into two groups：the patients in observation group were in trouble with urinary sepsis after the surgical treatments,and other patients in control group were normal.The differences of plasma PCT level between two groups were statistically analyzed.Result：The observation group included 48patients with urinary sepsis after surgical treatments,and the control group had 50patients.The difference of preoperative plasma PCT level in the two groups was not significant（P〉 0.05）.The postoperative plasma PCT levels in the two groups on the first day after the surgical treatment were significantly higher than the preoperative plasma PCT levels（P〈 0.05）.The postoperative plasma PCT level of the observation group on the first day after the surgical treatment was significantly higher than the control group（P〈0.01）.Conclusion：Plasma PCT can be measured as an early warning sign for urinary sepsis caused by complex urinary tract infection complicated by upper urinary tract calculi.