Wang Qing, Jiang Kehua, Chen Xiaolong, Zeng Guohua, Sun Fa
Guangzhou Medical University, Guangzhou, People's Republic of China.
Department of Urology, Guizhou Provincial People's Hospital, Guiyang, People's Republic of China.
Int J Gen Med. 2022 Sep 22;15:7407-7415. doi: 10.2147/IJGM.S379741. eCollection 2022.
This study aimed to assess the predictive value of preoperative albumin-globulin ratio (AGR) for systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL).
Patients who underwent PCNL in Guizhou Provincial People's hospital between August 2017 and July 2019 were enrolled and retrospectively reviewed. The primary clinical outcome of the current study was the development of SIRS within 48h after PCNL. Univariable and multivariable logistic regression analyses were conducted to verify the predictive value of AGR for post-PCNL SIRS. In addition, receiver operating characteristic (ROC) curves were generated to compare the discriminatory ability of AGR with other inflammatory biomarkers.
354 patients who underwent PCNL were enrolled and 66 patients (18.64%) developed postoperative SIRS. None of the patients suffered postoperative sepsis in our study. Multivariate analysis demonstrated that female sex (odds ratio [OR]=2.939, 95% odds ratio [OR]: 1.368-6.315, p = 0.006), CRP (OR = 1.008, 95% CI: 1.003-1.012, p = 0.001), and AGR (OR = 0.048, 95% CI: 0.010-0.239, p < 0.001) were all independent predictors for SIRS after PCNL. The optimal cut-off value of AGR for predicting postoperative SIRS was 1.145. In addition, AGR had a higher area under the curve (0.844) with sensitivity of 83.3% and specificity of 88.9% than C-reactive protein (0.808).
Preoperative AGR is a potential predictor for SIRS development after PCNL.
本研究旨在评估术前白蛋白-球蛋白比值(AGR)对经皮肾镜取石术(PCNL)后全身炎症反应综合征(SIRS)的预测价值。
纳入2017年8月至2019年7月在贵州省人民医院接受PCNL的患者,并进行回顾性分析。本研究的主要临床结局是PCNL后48小时内发生SIRS。进行单因素和多因素逻辑回归分析,以验证AGR对PCNL后SIRS的预测价值。此外,绘制受试者工作特征(ROC)曲线,比较AGR与其他炎症生物标志物的鉴别能力。
纳入354例行PCNL的患者,66例(18.64%)发生术后SIRS。本研究中无患者发生术后脓毒症。多因素分析表明,女性(比值比[OR]=2.939,95%比值比[OR]:1.368-6.315,p = 0.006)、CRP(OR = 1.008,95%置信区间:1.003-1.012,p = 0.001)和AGR(OR = 0.048,95%置信区间:0.010-0.239,p < 0.001)均为PCNL后SIRS的独立预测因素。预测术后SIRS的AGR最佳截断值为1.145。此外,AGR的曲线下面积(0.844)高于C反应蛋白(0.808),敏感性为83.3%,特异性为88.9%。
术前AGR是PCNL后SIRS发生的潜在预测指标。