Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Immunol. 2022 Nov 24;13:1017219. doi: 10.3389/fimmu.2022.1017219. eCollection 2022.
The aim of the current study was to evaluate the risk factors that influence the development of postoperative systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL), including cytokines and lymphocyte subsets.
A total of 154 patients who underwent PCNL at our hospital between October 2019 and January 2022 were retrospectively reviewed. The development of post-PCNL SIRS was the primary endpoint of the study. Univariable analysis and multivariable logistic regression analysis were performed to identify independent risk factors of post-PCNL SIRS. A nomogram was constructed using the independent risk factors, and receiver operating characteristic (ROC) curves were drawn.
There were 50 patients (32.5%) who developed SIRS after PCNL. In multivariate analysis, positive urine culture (odds ratio [OR], 3.556; = 0.048), long operation time (OR, 1.011; = 0.027), high IL-2R (OR, 1.002; = 0.018), low percentage of CD3 cells (OR 0.931; = 0.006), and high white blood cell (WBC) count (OR, 1.282 = 0.044) were independent risk factors for post-PCNL SIRS. These five significant variables were used to generate a nomogram that exhibited favorable fitting. The discrimination area under the ROC curves was 0.795.
Patients with long operation times, positive urine cultures, high interleukin 2 receptor, high white blood cell counts, and low percentages of CD3 cells may be at a higher risk of developing SIRS after PCNL. In these patients, cautious and comprehensive preoperative evaluations and appropriate treatment strategies should be considered.
本研究旨在评估影响经皮肾镜碎石取石术(PCNL)后全身炎症反应综合征(SIRS)发展的危险因素,包括细胞因子和淋巴细胞亚群。
回顾性分析 2019 年 10 月至 2022 年 1 月在我院接受 PCNL 的 154 例患者。PCNL 后 SIRS 的发生是本研究的主要终点。采用单因素分析和多因素逻辑回归分析确定 PCNL 后 SIRS 的独立危险因素。使用独立危险因素构建列线图,并绘制接受者操作特征(ROC)曲线。
术后 50 例(32.5%)患者发生 SIRS。多因素分析显示,尿培养阳性(优势比 [OR],3.556; = 0.048)、手术时间长(OR,1.011; = 0.027)、IL-2R 水平高(OR,1.002; = 0.018)、CD3 细胞比例低(OR,0.931; = 0.006)和白细胞计数高(OR,1.282; = 0.044)是 PCNL 后 SIRS 的独立危险因素。这 5 个显著变量被用于生成列线图,具有良好的拟合度。ROC 曲线下的鉴别面积为 0.795。
手术时间长、尿培养阳性、白细胞介素 2 受体水平高、白细胞计数高、CD3 细胞比例低的患者可能更易发生 PCNL 后 SIRS。对于这些患者,应考虑进行谨慎和全面的术前评估,并采取适当的治疗策略。