Clinical Significance Of Procalcitonin In The Early Diagnosis Of Urinary Sepsis After Percutaneous Nephrolithotomy

Objective:To investigate the clinical significance of monitoring plasma procalcitonin(PCT)levels in the early diagnosis of urosepsis after percutaneous nephrolithotomy(PCNL).Method:Retrospective analysis of 260 patients with upper urinary tract stones admitted to the Urology,China-Japan Union Hospital of Jilin University from January 2016 to October 2017.All the patients were underwent PCNL.32 cases occurred urinary sepsis postoperative,other 228 cases showed no symptom of infections.Urinary sepsis group as the observation group,the remaining 228 cases for the control group.To evaluate the diagnostic value of plasma PCT,CRP and white blood cells counts(WBCs)in urinary sepsis after PCNL by analyzing the levels of PCT,CRP and WBCs in preoperative,postoperative 6h and postoperative24h.Using the SPSS20.0 statistical software for datas processing,and drawing the Receiver Operating Characteristic Curve(ROC).Calculating the areas under the curve(AUC),and analysising of PCT,CRP and WBC on the diagnosis of urinary sepsis sensitivity,specificity and so on to evaluate the significance of PCT,CRP and WBC in the early diagnosis of urinary sepsis after PCNL.Result:There were no significant difference between the 2 groups(P>0.05)in the levels of PCT,CRP and WBCs at preoperative.The PCT levels of the two groups were(3.050±3.665)vs.(0.260±0.500)ng/ml postoperative 6h.The CRP levels were(37.520±14.630)vs.(18.360±18.150)mg/L.And the WBCs were(11.76±2.70)vs.(8.28±1.91)×10~9/L.There were significant difference between the 2 groups(P<0.05).The areas under the curve(AUC)of ROC of PCT,CRP and WBC were0.983,0.864 and 0.777 respectively.The sensitivity,specificity were(93.8%、93.2%),(87.5%、72.3%),(75.0%、76.4%)when the best cutoff value were 1.715ng/ml,31.31mg/L and 9.67×10~9/L.Conclusion:Compared with CRP and WBC,PCT has a higher sensitivity and specificity,and is more accurate in the early diagnosis of urosepsis.Monitoring of plasma procalcitonin level helps early diagnosis of urosepsis after PCNL.When the plasma PCT level is more than 1.715ng/ml,it has guiding significance for the diagnosis of urosepsis.