Predictive Value Of Inflammatory Compound Indexes For SIRS After Operation Of Upper Urinary Tract Stones

Research objectives:1.To analyze the risk factors of systemic inflammatory response syndrome(SIRS)in patients with upper urinary calculi after percutaneous nephrolithotomy(PCNL)and retrograde flexible ureteroscopic lithotripsy(FUL).2.Evaluation of inflammation complex indicators: immune inflammation index(SII),platelet count/lymphocyte count ratio(PLR),neutrophils/lymphocyte ratio(NLR),etc.in the detection of SIRS after PCNL and FURL.Materials and methods:Clinical data of 316 patients with PCNL and 204 patients with FURL treated in the Second Affiliated Hospital of Guangxi Medical University from January 2018 to December 2020 were retrospectively collected.Patients according to different ways of two kinds of operation can be divided into PCNL and FURL group,then each group according to the criteria for the diagnosis of sepsis in patients with SIRS subgroups within each group and non SIRS group,and then to statistical analysis of the clinical data of patients,their difference is obtained by single factor analysis of significant observation index,then put the multi-factor logistic regression analysis to these indexes,the occurrence of SIRS respectively related risk factors.Finally,the sensitivity and specificity of positive predictors were analyzed by receiver operating characteristic(ROC)curve.The results:Among the 316 patients in the PCNL group who met the inclusion criteria,106 patients developed SIRS after surgery and 210 patients in the non-SIRS group.There were 202 patients in the FUL group,22 patients developed SRIs after surgery,and 182 patients in the non-SIRS group.Univariate analysis showed that there were significant differences in preoperative leukocytes,neutrophils,lymphocytes,monocytes,stone load,operative time,intraoperative blood loss,NLR,SII,PLR,LMR and other subgroup variables between the two groups(P < 0.05).Logistics regression multivariate analysis showed that preoperative white blood cell count,operative time,SII and NLR of PCNL group showed statistically significant differences,which may be high risk factors.The results of FURL group showed that preoperative white blood cell count,operative time and NLR were the high risk factors for SIRS.By ROC curve,the postoperative SIRS in the PCNL group and the FURL group were used as the end points of preoperative white blood cell count,SII,NLR and PLR,respectively.We preliminarily discussed the efficacy of the test and observed that the areas under the AUC curve in the PCNL group were 0.761,0.825,0.835,and 0.657,respectively.The areas under the AUC curve in Furl group were0.780,0.927,0,897 and 0.639,respectively.