Early Warning Effect of CHR, NLR and U-HBP on SIRS in Patients with Upper Urinary Tract Calculus After Flexible Ureteroscopic Lithotripsy.

OBJECTIVE

Rising upper urinary tract calculus (UUTC) cases demand effective treatment. FUL, while efficient, poses infection risks and SIRS. This study explores CHR, NLR, and U-HBP as potential SIRS predictors post-FUL in UUTC patients, aiming to improve early detection and enhance SIRS management.

METHODS

A retrospective analysis was conducted on data from 216 UUTC patients who underwent FUL between April 2020 and April 2023. Occurrence of SIRS post-FUL was studied. Patients were categorized into SIRS and non-SIRS groups. CHR, NLR, and U-HBP levels were compared. Predictive value of CHR, NLR, and U-HBP for SIRS was assessed. Univariate and multivariate logistic regression analyses identified SIRS influencing factors.

RESULTS

In a study involving 216 patients undergoing Flexible Ureteroscopic Holmium Laser Lithotripsy (FUL), Systemic Inflammatory Response Syndrome (SIRS) occurred in 20.83% of cases. Patients with SIRS exhibited significantly elevated levels of C-reactive protein to High-density lipoprotein cholesterol ratio (CHR) (9.26 ± 2.17 vs. 3.89 ± 0.92), Neutrophil to Lymphocyte Ratio (NLR) (5.21 ± 0.98 vs. 2.62 ± 0.49), and Urinary Heparin Binding Protein (U-HBP) (3.01 ± 0.51 ng/L vs. 1.22 ± 0.19 ng/L) compared to the non-SIRS group. Multivariate analysis identified factors such as infected stones (OR = 3.294), stone size ≥ 30 mm (OR = 2.034), CHR ≥ 8.76 (OR = 4.554), NLR ≥ 3.74 (OR = 3.951), and U-HBP ≥ 1.55 ng/L (OR = 4.884) as significant predictors for SIRS. These findings emphasize the pivotal role of these biomarkers and stone characteristics in predicting inflammatory responses post-FUL surgery.

CONCLUSION

This study establishes the predictive power of elevated C-reactive protein to High-density lipoprotein cholesterol ratio (CHR), Neutrophil to Lymphocyte Ratio (NLR), and Urinary Heparin Binding Protein (U-HBP) levels for Systemic Inflammatory Response Syndrome (SIRS) post Flexible Ureteroscopic Holmium Laser Lithotripsy (FUL) in upper urinary tract calculi patients. Stone characteristics, including infected stones and stone size ≥ 30 mm, are also key indicators of SIRS. These findings offer crucial insights for effective post-operative management, enhancing outcomes in urinary calculi treatment.