Gong Jue, Ouyang Wei, Liu Wen, Yin Guangming, Yuan Peng
Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Ann Med. 2025 Dec;57(1):2512113. doi: 10.1080/07853890.2025.2512113. Epub 2025 Jun 2.
It was hypothesized that perirenal fat (PRF) might be associated with systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL). The aim of this study was to investigate risk factors, including perirenal fat thickness (PRFT), that may contribute to SIRS after PCNL.
169 patients with unilateral renal stones who underwent PCNL at our institution between January 2020 and December 2023 were retrospectively included. Based on the occurrence of SIRS after PCNL, patients were divided into non-SIRS group ( = 136) and SIRS group ( = 33). Independent risk factors for the development of SIRS after PCNL were identified by using univariable and multivariable logistic regression analyses.
It was found that PRFT at the surgical side was significantly higher in patients with SIRS than those without SIRS (median 4.8 cm vs. 5.2 cm, = 0.029). The results of univariate logistic regression analysis showed that high PRFT ( = 0.005), diabetes ( = 0.016), high serum procalcitonin ( = 0.004), and positive urine culture (= 0.008) were associated with SIRS after PCNL. The results of multivariable logistic regression analysis revealed that high PRFT (OR 1.263, 95% CI 1.046-1.524; = 0.027), diabetes (OR 4.012, 95% CI 1.494-10.773; = 0.035), high serum procalcitonin (OR 1.367, 95% CI 1.095-2.086; = 0.006), and positive urine culture (OR 3.574, 95% CI 1.092-11.700; = 0.015) might be independent predictors for SIRS after PCNL.
Patients with high PRFT, diabetes, high serum procalcitonin, and positive urine culture may be at a higher risk of SIRS after PCNL. Preoperative comprehensive evaluation and postoperative close monitor should be considered on these patients.
研究假设肾周脂肪（PRF）可能与经皮肾镜取石术（PCNL）后的全身炎症反应综合征（SIRS）相关。本研究旨在调查可能导致PCNL术后发生SIRS的危险因素，包括肾周脂肪厚度（PRFT）。
回顾性纳入2020年1月至2023年12月在我院接受PCNL的169例单侧肾结石患者。根据PCNL术后SIRS的发生情况，将患者分为非SIRS组（n = 136）和SIRS组（n = 33）。采用单因素和多因素logistic回归分析确定PCNL术后发生SIRS的独立危险因素。
发现SIRS患者手术侧的PRFT显著高于无SIRS患者（中位数4.8 cm对5.2 cm，P = 0.029）。单因素logistic回归分析结果显示，高PRFT（P = 0.005）、糖尿病（P = 0.016）、高血清降钙素原（P = 0.004）和尿培养阳性（P = 0.008）与PCNL术后SIRS相关。多因素logistic回归分析结果显示，高PRFT（OR 1.263，95%CI 1.046 - 1.524；P = 0.027）、糖尿病（OR 4.012，95%CI 1.494 - 10.773；P = 0.035）、高血清降钙素原（OR 1.367，95%CI 1.095 - 2.086；P = 0.006）和尿培养阳性（OR 3.574，95%CI 1.092 - 11.700；P = 0.015）可能是PCNL术后SIRS的独立预测因素。
PRFT高、糖尿病、高血清降钙素原和尿培养阳性的患者PCNL术后发生SIRS的风险可能更高。应对这些患者进行术前综合评估和术后密切监测。
