Value Of Neutrophils CD64,Serum Amyloid A And Procalcitonin In Diagnosis Of Urosepsis Following Urinary Calculi Surgery

Objective: To compare and analyze the value of neutrophil CD64(nCD64)index,serum amyloid A(SAA),procalcitonin(PCT)and high sensitivity C-reactive protein Protein(hs-CRP)in the early diagnosis of urosepsis after urinary calculi surgery.Methods: From October 2019 to December 2020,the clinical data of 100 patients with urolithiasis who underwent surgical treatment in our hospital were collected.Among them,49 patients underwent percutaneous nephrolithotomy(PCNL)and 51 patients underwent flexible ureteroscopic lithotripsy(FURL),which were divided into two groups according to whether urosepsis was diagnosed after operation.Compared the preoperative baseline data and postoperative levels of nCD64 index,SAA,PCT,and hsCRP between the two groups of patients.Multivariate analysis was used to compare the correlation between the four postoperative indicators and urosepsis,and the value of nCD64 index,SAA,PCT and hs-CRP as well as the combined detection of the three indexes in diagnosis of urosepsis following urinary calculi surgery was evaluated by using receiver operating characteristic(ROC)curve.Results: The average levels of nCD64 index,SAA,PCT and hs-CRP in urosepsis group were significantly higher than those in the non-sepsis group,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis revealed that nCD64 index(B=2.732,P<0.05)and PCT(B=0.689,P<0.05)were significantly associated with postoperative urosepsis.By ROC curve,the area under the ROC curve of nCD64index(0.934)was higher than SAA(0.806),PCT(0.830)and hs-CRP(0.785)for diagnosing urosepsis after urinary calculi surgery;When the cut-off value of nCD64 index in diagnosing urosepsis was 1.12,its sensitivity was 83.30%,and the specificity was 90.00%,which was higher than SAA(sensitivity 66.70%,specificity81.40%),PCT(sensitivity 76.70%,specificity 88.60%)and hs-CRP(sensitivity 80.00%,specificity 70.00%).Compared with SAA,PCTand hs-CRP,nCD64 index has a better diagnostic effect.The area under ROC curve for diagnosis of urosepsis after urolithiasis surgery was 0.965,the sensitivity was 96.7%and the specificity was 92.90%,which was significantly higher than that of the single detection and could further improve the diagnostic efficiency.Conclusion: nCD64 index,SAA,PCT,and hs-CRP are all helpful for the early diagnosis of urosepsis after urinary calculi surgery.Among them,the nCD64 index has a better value in the early diagnosis of postoperative urosepsis.The combined detection of four items can improve detection efficiency,which is superior to simple index detection in diagnosis of sepsis,and it is worthy of wide clinical application.