Altern Ther Health Med. 2024 Jun;30(6):196-202.
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.
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.
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.
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.
上尿路结石（UUTC）病例不断增加，需要有效的治疗。钬激光碎石术（FUL）虽然有效，但存在感染风险和全身炎症反应综合征（SIRS）的风险。本研究旨在探讨 CHR、NLR 和 U-HBP 是否可作为 UUTC 患者 FUL 后 SIRS 的潜在预测因子，以改善早期检测并加强 SIRS 管理。
对 2020 年 4 月至 2023 年 4 月期间接受 FUL 的 216 例 UUTC 患者的数据进行回顾性分析。研究 FUL 后 SIRS 的发生情况。将患者分为 SIRS 组和非 SIRS 组。比较 CHR、NLR 和 U-HBP 水平。评估 CHR、NLR 和 U-HBP 对 SIRS 的预测价值。采用单因素和多因素逻辑回归分析确定 SIRS 的影响因素。
在一项涉及 216 例接受钬激光碎石术（FUL）治疗的患者的研究中，20.83%的患者发生了全身炎症反应综合征（SIRS）。与非 SIRS 组相比，SIRS 组患者的 C 反应蛋白与高密度脂蛋白胆固醇比值（CHR）（9.26±2.17 比 3.89±0.92）、中性粒细胞与淋巴细胞比值（NLR）（5.21±0.98 比 2.62±0.49）和尿肝素结合蛋白（U-HBP）（3.01±0.51ng/L 比 1.22±0.19ng/L）显著升高。多因素分析确定了感染性结石（OR=3.294）、结石大小≥30mm（OR=2.034）、CHR≥8.76（OR=4.554）、NLR≥3.74（OR=3.951）和 U-HBP≥1.55ng/L（OR=4.884）等因素是 SIRS 的显著预测因子。这些发现强调了这些生物标志物和结石特征在预测 FUL 术后炎症反应中的重要作用。
本研究确立了 C 反应蛋白与高密度脂蛋白胆固醇比值（CHR）、中性粒细胞与淋巴细胞比值（NLR）和尿肝素结合蛋白（U-HBP）水平升高对上尿路结石患者钬激光碎石术后全身炎症反应综合征（SIRS）的预测作用。结石特征，包括感染性结石和结石大小≥30mm，也是 SIRS 的关键指标。这些发现为术后管理提供了重要的见解，改善了尿路结石治疗的结果。
