摘要
目的:探究术前中性粒细胞-淋巴细胞比(NLR)与血小板-淋巴细胞比(PLR)对经皮肾镜碎石取石术(PCNL)后发生全身炎症反应综合征(SIRS)的预测作用。方法:回顾性分析2015-2018年经PCNL治疗的147例肾结石患者临床资料。根据患者术后是否发生SIRS,将患者分为SIRS组和非SIRS组,研究术前NLR、PLR等多种临床指标与术后发生SIRS的关系。使用多因素Logistic回归模型评估单因素分析中的显著性变量,确定PCNL后发生SIRS的独立危险因素。结果:单因素分析显示,SIRS组患者的术前PLR(P<0.001),术前NLR(P=0.012),术后血红蛋白下降程度(P=0.035),有残余结石比例(P=0.026)显著高于非SIRS组患者,多因素分析结果显示,PLR(OR=1.039,P=0.001)是PCNL术后发生SIRS的独立因素。ROC曲线分析结果提示,PLR用于预测SIRS发生的最佳界值为130.8,此时的曲线下面积为87.3%、灵敏度为63.4%、特异度为85.0%。结论:PLR是PCNL术后发生SIRS的独立危险因素。对于术前PLR值>130.8的患者,应注意预防SIRS的发生。
Objective:To explore the predictive value of preoperative neutrophil-lymphocyte ratio(NLR)and platelet-lymphocyte ratio(PLR)for the development of postoperative systemic inflammatory response syndrome(SIRS)in percutaneous nephrolithotomy(PCNL).Methods:In the present study,we retrospectively recorded clinical data of 147 renal stone patients undergoing PCNL between 2015 and 2018.Forty-one out of 147(27.9%)patients developed to SIRS after surgery.We divided patients into SIRS group and non-SIRS group.The relationship between the occurrence of postoperative SIRS and preoperative NLR,PLR and other clinical indexes was analyzed.The binary logistic regression was used to detect independent risk factors for SIRS after PCNL.Results:The univariate analysis revealed that the SIRS patients had significantly higher values of preoperative NLR(P=0.012),preoperative PLR(P<0.001),hemoglobin decrease(P=0.035)and rate of residual stones(P=0.026)than non-SIRS patients.The Multivariate analysis suggested that only PLR was the independent factor for the development of SIRS.The ROC analysis showed the best cut-off value of PLR in predicting postoperative SIRS was 130.8,and the values of AUC,sensitivity and specificity were 87.3%,63.4%and 85.0%respectively.Conclusion:Preoperative PLR is an effective index in predicting the occurrence of SIRS after PCNL.Preoperative interventions to prevent the development of postoperative SIRS are imperative for renal stone patients with PLRs more than 130.8.
作者
王羿翔
李明山
刘屹立
王平
WANG Yixiang;LI Mingshan;LIU Yili;WANG Ping(Department of Urology,the Fourth Hospital Affiliated to China Medical University,Shenyang 110032,China)
出处
《微创泌尿外科杂志》
2019年第5期340-344,共5页
Journal of Minimally Invasive Urology
作者简介
通信作者:王平,cmu4h-wp@126.com
