Wu Yuyun, Wang Guang, Huang Ziye, Yang Bowei, Yang Tongxin, Liu Jianhe, Li Pei, Li Jiongming
The Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P.R. China.
The Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dian-Mian Avenue, Kunming 650101, Yunnan, P.R. China.
Ther Adv Urol. 2023 Jan 31;15:17562872231151852. doi: 10.1177/17562872231151852. eCollection 2023 Jan-Dec.
Urosepsis is sepsis caused by urogenital tract infection and is one of the most common critical illnesses in urology. If urosepsis is not diagnosed early, it can rapidly progress and worsen, leading to increased mortality. In recent years, with the increase of urinary tract surgery, the incidence of urosepsis continues to rise, posing a serious threat to patients. Early diagnosis of urosepsis, timely and effective treatment can greatly reduce the mortality of patients. Biomarkers such as WBC, NLR, PCT, IL-6, CRP, lactate, and LncRNA all play specific roles in the early diagnosis or prognosis of urosepsis. In addition to the abnormal increase of WBC, we should be more alert to the rapid decline of WBC. NLR values were superior to WBC counts alone in predicting infection severity. Compared with several other biomarkers, PCT values can differentiate between bacterial and non-bacterial sepsis. IL-6 always has high sensitivity and specificity for the diagnosis of sepsis, and CRP also has high sensitivity and specificity for the diagnosis of urosepsis. Lactic acid is closely related to the prognosis of patients with urosepsis. LncRNAs may be potential biomarkers of urosepsis. This article summarizes the main biomarkers, hoping to provide a reference for the timely diagnosis and evaluation of urosepsis.
泌尿道脓毒症是由泌尿生殖道感染引起的脓毒症，是泌尿外科最常见的危重病之一。如果泌尿道脓毒症不能早期诊断，它会迅速进展并恶化，导致死亡率增加。近年来，随着尿路手术的增加，泌尿道脓毒症的发病率持续上升，对患者构成严重威胁。早期诊断泌尿道脓毒症，及时有效的治疗可大大降低患者的死亡率。白细胞（WBC）、中性粒细胞与淋巴细胞比值（NLR）、降钙素原（PCT）、白细胞介素-6（IL-6）、C反应蛋白（CRP）、乳酸和长链非编码RNA（LncRNA）等生物标志物在泌尿道脓毒症的早期诊断或预后中均发挥特定作用。除了白细胞异常升高外，我们更应警惕白细胞的迅速下降。NLR值在预测感染严重程度方面优于单纯的白细胞计数。与其他几种生物标志物相比，PCT值可区分细菌性和非细菌性脓毒症。IL-6对脓毒症的诊断始终具有高敏感性和特异性，CRP对泌尿道脓毒症的诊断也具有高敏感性和特异性。乳酸与泌尿道脓毒症患者的预后密切相关。LncRNAs可能是泌尿道脓毒症的潜在生物标志物。本文总结了主要生物标志物，希望为泌尿道脓毒症的及时诊断和评估提供参考。
