白蛋白与球蛋白比值作为输尿管镜碎石术后发热性尿路感染预测指标的意义

Significance of albumin to globulin ratio as a predictor of febrile urinary tract infection after ureteroscopic lithotripsy.

作者信息

Yi Seung Yun, Park Dong Jin, Min Kyungchan, Chung Jae-Wook, Ha Yun-Sok, Kim Bum Soo, Kim Hyun Tae, Kim Tae-Hwan, Yoo Eun Sang

机构信息

Department of Urology, Kyungpook National University Hospital, Daegu, Korea.

Department of Urology, Dongguk University Gyeonju Hospital, Gyeongju, Korea.

出版信息

Yeungnam Univ J Med. 2021 Jul;38(3):225-230. doi: 10.12701/yujm.2021.00955. Epub 2021 Apr 20.

DOI:10.12701/yujm.2021.00955

PMID:33874652

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8225490/

Abstract

BACKGRUOUND

We aimed to analyze the effectiveness of albumin to globulin ratio (AGR) in predicting postoperative febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URS) and retrograde intrarenal surgery (RIRS).

METHODS

From January 2013 to May 2018, 332 patients underwent URS and RIRS. The rate of postoperative fUTI and risk factors for postoperative fUTI were analyzed using logistic regression. Patients were divided into postoperative fUTI and non-postoperative fUTI (non-fUTI) groups. AGR with other demographic and perioperative data were compared between the two groups to predict the development of fUTI after URS.

RESULTS

Of the 332 patients, postoperative fUTI occurred in 41 (12.3%). Preoperative pyuria, microscopic hematuria, diabetes mellitus, hypoalbuminemia, and hyperglobulinemia were more prevalent in the fUTI group. Patients in the fUTI group had larger stone size, lower preoperative AGR, longer operation time, and longer preoperative antibiotic coverage period. In a multivariable logistic analysis, preoperative pyuria, AGR, and stone size were independently correlated with postoperative fUTI (p<0.001, p=0.008, and p=0.041, respectively). Receiver operating curve analysis showed that the cutoff value of AGR that could predict a high risk of fUTI after URS was 1.437 (sensitivity, 77.3%; specificity, 76.9%), while the cutoff value of stone size was 8.5 mm (sensitivity, 55.3%; specificity, 44.7%).

CONCLUSION

This study demonstrated that preoperative pyuria, AGR, and stone size can serve as prognostic factors for predicting fUTI after URS.

摘要

背景

我们旨在分析白蛋白与球蛋白比值（AGR）在预测输尿管镜碎石术（URS）和逆行肾内手术（RIRS）后发热性尿路感染（fUTI）方面的有效性。

方法

2013年1月至2018年5月，332例患者接受了URS和RIRS。采用逻辑回归分析术后fUTI的发生率及术后fUTI的危险因素。将患者分为术后fUTI组和非术后fUTI（非fUTI）组。比较两组之间的AGR以及其他人口统计学和围手术期数据，以预测URS后fUTI的发生情况。

结果

在332例患者中，41例（12.3%）发生了术后fUTI。术前脓尿、镜下血尿、糖尿病、低白蛋白血症和高球蛋白血症在fUTI组中更为常见。fUTI组患者的结石尺寸更大、术前AGR更低、手术时间更长以及术前抗生素覆盖期更长。在多变量逻辑分析中，术前脓尿、AGR和结石尺寸与术后fUTI独立相关（分别为p<0.001、p=0.008和p=0.041）。受试者工作特征曲线分析显示，预测URS后fUTI高风险的AGR临界值为1.437（敏感性为77.3%；特异性为76.9%），而结石尺寸的临界值为8.5 mm（敏感性为55.3%；特异性为44.7%）。