Prediction Of Urinary Sepsis After Minimally Invasive Intracavitary Lithotripsy By Peripheral Blood Inflammation-related Indicators

OBJECTIVE: To investigate the clinical significance of peripheral inflammatory markers in predicting pyemia after endolithotripsy.METHODS: A retrospective analysis of 153 patients with endolithotripsy(percutaneous nephroscope lithoipsy)in our department of urology from October 2016 to December 2018 was conducted according to the selection and exclusion criteria,including 98 males and 55 females.There were 39 cases of hypertension and 114 cases without hypertension.There were 14 cases of diabetes mellitus and 139 cases of absence of diabetes mellitus.There were 17 other diseases and 136 other diseases.There were 124 cases of hydronephrosis and 29 cases without hydronephrosis.51 cases of urinary pyemia occurred in the observation group(observation group),and 102 cases of urinary pyemia did not occur(control group).The changes of serum PCT,CRP,IL-6,WBC and other indicators were compared between the two groups.RESULTS: The t-test was used for comparison between independent groups.The count data were expressed by n(%).After single factor analysis,the two groups of patients were only gender,PCT,CRP,IL-6,WBC,neutrophils.There were significant differences in the scores of 100,neutrophil count and urinary white blood cell count(both P<0.05),and they were brought into multivariate logistic regression analysis to compare the differences.The results showed that PCT and CRP were independent factors influencing the incidence of pyemia,and all of them were independent risk factors for pyemia incidence,PCT(B=4.363,P=0.015),CRP(B=0.045,P=0.019);The larger the PCT and CRP were,the higher the incidence of pyemia was.Using the ROC curve to test the predicted value of the indicator,the AUC of PCT was 0.884(95% CI 0.826-0.943,P<0.05).When the cutoff value was 0.075,the sensitivity was 82.4% and the specificity was 79.4%.The AUC of CRP was 0.718(95% CI 0.619-0.817,P<0.05),taking a cutoff value of 18.4565,sensitivity of 58.8%,specificity of 87.3%;CONCLUSION: PCT and CRP have predictive value for urinary sepsis after minimally invasive endolithotripsy,and the predictive value of PCT is greater than that of CRP.