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初步研究:术前降钙素原在预测基线尿培养阴性的微创经皮肾镜取石术后发热中的作用。

A preliminary study: the role of preoperative procalcitonin in predicting postoperative fever after mini-percutaneous nephrolithotomy in patients with a negative baseline urine culture.

机构信息

Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Hongkou District, Shanghai, 200080, People's Republic of China.

Department of Gerontology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Road, Hongkou District, Shanghai, People's Republic of China.

出版信息

Urolithiasis. 2019 Oct;47(5):455-460. doi: 10.1007/s00240-019-01115-3. Epub 2019 Feb 12.

DOI:10.1007/s00240-019-01115-3
PMID:30747240
Abstract

To evaluate the role of preoperative procalcitonin (PCT) levels in predicting postoperative fever after mini-percutaneous nephrolithotomy (mini-PCNL) in patients with a negative baseline urine culture. Between January 2014 and October 2017, 329 patients with a negative baseline urine culture and who underwent mini-PCNL were enrolled in this study. Patients were stratified into the control or febrile group based on a body temperature either less than or greater than 38 °C, respectively. Demographic and perioperative data were compared between the groups, and variables found to be statistically significant were included in a binary logistic regression analysis. A total of 68 (20.6%) patients experienced postoperative fever. The univariate analysis revealed a statistically significant difference between groups in preoperative fever (p = 0.032), stone burden (p < 0.001), C-reactive protein (p = 0.011), PCT (p < 0.001) and interleukin-6 (p = 0.035) levels. Binary logistic regression analysis indicated that stone burden > 353 mm (p = 0.003) and PCT > 0.05 ng/mL (p < 0.001) are independent risk factors for postoperative fever in mini-PCNL-treated patients with a negative baseline urine culture. We concluded that patients with stone burden > 353 mm or PCT > 0.05 ng/mL were more likely to develop postoperative fever after mini-PCNL, though with a negative baseline urine culture.

摘要

目的

评估术前降钙素原(PCT)水平在预测阴性基线尿培养的微创经皮肾镜取石术(mini-PCNL)后发热中的作用。

方法

2014 年 1 月至 2017 年 10 月,纳入 329 例基线尿培养阴性且接受 mini-PCNL 的患者。根据体温(<38℃或>38℃)将患者分为对照组或发热组。比较两组患者的一般资料和围手术期数据,将具有统计学意义的变量纳入二项逻辑回归分析。

结果

共 68 例(20.6%)患者发生术后发热。单因素分析显示,两组患者术前发热(p=0.032)、结石负荷(p<0.001)、C 反应蛋白(p=0.011)、PCT(p<0.001)和白细胞介素-6(p=0.035)水平存在统计学差异。二项逻辑回归分析表明,结石负荷>353mm(p=0.003)和 PCT>0.05ng/ml(p<0.001)是阴性基线尿培养 mini-PCNL 术后发热的独立危险因素。

结论

尽管基线尿培养阴性,但结石负荷>353mm 或 PCT>0.05ng/ml 的患者更易发生 mini-PCNL 术后发热。

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Curr Urol Rep. 2016 Apr;17(4):30. doi: 10.1007/s11934-016-0591-5.
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Urosepsis--Etiology, Diagnosis, and Treatment.泌尿道感染——病因、诊断与治疗
Dtsch Arztebl Int. 2015 Dec 4;112(49):837-47; quiz 848. doi: 10.3238/arztebl.2015.0837.
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Can procalcitonin monitoring reduce the length of antibiotic treatment in bloodstream infections?降钙素原监测能否缩短血流感染的抗生素治疗时间?
联合应用降钙素原、C 反应蛋白和血清淀粉样蛋白 A 诊断尿路感染所致脓毒症。
Int Urol Nephrol. 2024 Jul;56(7):2141-2146. doi: 10.1007/s11255-024-03959-0. Epub 2024 Feb 20.
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Preoperative inflammatory biomarkers analysis in prognosis of systemic inflammatory response syndrome following percutaneous nephrolithotomy: A systematic review and meta-analysis.经皮肾镜取石术后全身炎症反应综合征预后的术前炎症生物标志物分析:一项系统评价和荟萃分析
Arab J Urol. 2022 Oct 31;21(2):108-117. doi: 10.1080/2090598X.2022.2138891. eCollection 2023.
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