Abstract：【Objective】 To investigate the predictive value of heparin binding protein (HBP), soluble CD14 subtype (sCD14-ST) and infection probability (IPS) scores on urinary sepsis after percutaneous nephrolithotomy (PCNL). 【Methods】 From January 2018 to January 2021, 44 patients with urinary sepsis after PCNL were selected as the observation group, and 44 patients without urinary sepsis after PCNL were selected as the control group. The clinical data, urinary HBP, serum sCD14-ST levels and IPS scores of the two groups were compared. The correlation between urinary HBP, serum sCD14-ST levels and IPS scores was analyzed. The influencing factors of urinary sepsis after PCNL were analyzed. The predictive value of each index for urinary sepsis after PCNL was evaluated. 【Results】 The positive rate of urine culture before operation in the observation group was higher than that in the control group, the operation time was longer than that in the control group, and the urine HBP, serum sCD14-ST levels and IPS scores were higher than those in the control group(P<0.05). Pearson correlation analysis showed that urine HBP, serum sCD14-ST levels were positively correlated with IPS scores (r=0.608, 0.534, P<0.05). Logistic regression analysis showed that positive urine culture before operation, operation time, urine HBP, serum sCD14-ST, IPS score were the influencing factors of urinary sepsis caused by PCNL (P<0.05). The AUC of urine HBP, serum sCD14-ST and IPS scores for predicting urinary sepsis after PCNL was 0.909, 95%CI was 0.828～0.960, sensitivity was 95.45%, specificity was 75.00%, which was significantly higher than those predicted by the three alone.【Conclusion】Urine HBP, serum sCD14-ST and IPS scores are the influencing factors of urinary sepsis after PCNL. The combined detection can be used as an important method to predict the occurrence of urinary sepsis.
张晓荣, 李微. HBP、sCD14-ST与IPS评分对PCNL术后发生尿源性脓毒血症的预测价值[J]. 医学临床研究, 2022, 39(9): 1345-1348.
ZHANG Xiao-rong, LI Wei. Predictive Value of HBP, sCD14-ST and IPS Scores for Urinary Sepsis after PCNL. JOURNAL OF CLINICAL RESEARCH, 2022, 39(9): 1345-1348.
[1] ADHIKARI M B,KARNA S,ADHIKARI K,et al.Percutaneous nephrolithotomy in paediatric population:a single center experience[J].J Nepal Health Res Counc,2020,18(2):205-209.
[2] 袁志浩,张中元,王刚,等.经皮肾镜取石术后发热及全身炎症反应综合征单中心187例经验分析[J].临床泌尿外科杂志,2019,34(4):301-304.
[3] 刘文慧,甘建和,秦爱兰.降钙素原联合感染可能性评分对肝衰竭患者并发感染的预测价值[J].临床肝胆病杂志,2019,35(9):1995-2000.
[4] 邓道庭,柳俊喜,张红.尿肝素结合蛋白和尿白细胞酯酶检测在经尿道前列腺切除术后尿路感染诊断中的应用[J].中国性科学,2020,29(11):20-22.
[5] GAD G I,SHINKAR D M,KAMEL EL-DIN M M,et al.The utility of soluble CD14 subtype in early diagnosis of culture-proven early-onset neonatal sepsis and prediction of outcome[J].Am J Perinatol,2020,37(5):497-502.
[6] 叶章群.泌尿外科疾病诊疗指南[M].北京:科学出版社,2013:78-79.
[7] AWAN A S,MITHANI S,YOUSUF F,et al.Percutaneous nephrolithotomy in a previously operated kidney[J].J Coll Physicians Surg Pak,2020,30(11):1201-1205.
[8] KOCAK S,ACAR T,ERTEKIN B,et al.The role of heparin-binding protein in the diagnosis of acute mesenteric ischemia[J].Ulus Travma Acil Cerrahi Derg,2019,25(3):205-212.
[9] 陈世东,张翠霞,洪国粦,等.肝素结合蛋白对成人脓毒症诊断效能的Meta分析[J].中华危重病急救医学,2019,31(11):1330-1334.
[10] 金力芳,葛秋华,刘小香.尿液肝素结合蛋白检测在尿路感染中的诊断价值[J].中国卫生检验杂志,2020,30(7):824-826.
[11] 沈悦凡,李辉,姚自翔,等.尿肝素结合蛋白在尿源性脓毒血症中的诊断价值[J].浙江医学,2019,41(13):1428-1430.
[12] 赵元明,陆书华,申爱华,等.可溶性CD14亚型检测作为脓毒血症标志物的探讨[J].中国实验诊断学,2019,23(5):804-806.
[13] 朱澄村,程帆,宁金卓.生物标志物对尿源性脓毒血症临床预警的研究进展[J].医学综述,2019,25(6):1095-1098.
[14] 费志永,董宏,钱秦娟,等.危重症感染患者IPS评分、PCT、CRP及D-D水平的变化及临床意义[J].海南医学,2018,29(8):1108-1110.
2022, Vol. 39 
