术前系统免疫炎症指数及术中感染迹象在预测输尿管软镜逆行腔内碎石术后尿源性感染中的价值

doi:10.3969/j.issn.1006-6233.2026.02.011

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摘要 目的: 探究术前系统免疫炎症指数(SⅡ)及术中感染迹象在预测输尿管软镜逆行腔内碎石术后尿源性感染中的价值。方法: 研究对象选择为2022年1月至2024年12月医院收治的210例行输尿管软镜逆行腔内碎石术治疗的患者,根据术后尿源性感染情况分为感染组与未感染组,统计患者资料、术前SⅡ以及术中感染迹象,术后尿源性感染影响因素的探究采用多因素Logistic回归分析,绘制受试者工作特征(ROC)曲线分析术前SⅡ的预测效能,计算并比较术前SⅡ及术中感染迹象的敏感度与特异度。结果: 感染组术前SⅡ高于未感染组,术中感染迹象患者数多于未感染组,差异有统计学意义(P<0.05);感染组血红蛋白水平低于未感染组,尿素氮、血肌酐、白细胞计数(WBC)水平高于未感染组,差异有统计学意义(P<0.05);多因素Logistic回归分析,结果显示术前SⅡ、术中感染迹象以及WBC为输尿管软镜逆行腔内碎石术后尿源性感染的影响因素(P<0.05);ROC曲线分析结果显示以609×10⁹L^-1为截断值,术前SⅡ预测术后尿源性感染的曲线下面积值(AUC)为0.982,敏感度、特异度为94.44%、93.10%;术中感染迹象预测术后尿源性感染的敏感度、特异度为52.78%、90.23%,术前SⅡ的敏感度显著高于术中感染迹象,差异有统计学意义(P<0.05),两种指标的特异度比较差异无统计学意义(P>0.05)。结论: 输尿管软镜逆行腔内碎石术后尿源性感染的影响因素包括术前SⅡ、术中感染迹象以及WBC水平,术前SⅡ、术中感染迹象对患者术后尿源性感染具有良好的预测效能且以术前SⅡ的预测效能最佳。

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关键词 ：输尿管软镜逆行腔内碎石术, 尿源性感染, 系统免疫炎症指数, 感染迹象

Abstract：Objective: To explore the value of preoperative systemic immune-inflammation index (SII) and intraoperative signs of infection in predicting urinary tract infection after ureteroscopic retrograde intracavitary lithotripsy. Methods: From January 2022 to December 2024, 210 patients with ureteroscopic retrograde intracavitary lithotripsy were selected as the research subjects. They were divided into an infected group and an uninfected group based on whether they had urinary infection after surgery. Their data, preoperative SII, and intraoperative infection signs of infection were statistically analyzed. The factors influencing postoperative urinary infection were identified through multivariate logistic regression. The receiver operating characteristic (ROC) curves were plotted to analyze the predictive efficacy of preoperative SII, and the sensitivity and specificity of preoperative SII and intraoperative infection signs were calculated and compared. Results: Preoperative SII of the infected group was higher than that of the uninfected group, and there were more patients with intraoperative signs of infection in the infected group than in the uninfected group before surgery (P<0.05). Hemoglobin level in the infected group was lower than that in the uninfected group, while blood urea nitrogen, serum creatinine and White blood cell(WBC) levels were higher than those in the uninfected group (P<0.05). Multivariate logistic regression analysis results showed that preoperative SII, intraoperative sign of infection, and WBC were influencing factors of urinary infection after ureteroscopic retrograde intracavitary lithotripsy (P<0.05). ROC curve analysis results showed that with 609×10⁹L^-1 as the cut-off value, the area under the curve (AUC) of preoperative SII in predicting postoperative urinary infection was 0.982, the sensitivity and specificity were 94.44% and 93.10%, respectively. The sensitivity and specificity of intraoperative infection signs in predicting postoperative urinary infection were 52.78% and 90.23%, respectively. The sensitivity of preoperative SII was significantly higher than that of intraoperative infection signs, and the difference was statistically significant (P<0.05). There was no statistically significant difference in specificity between the two indicators (P>0.05). Conclusion: The influencing factors of postoperative urinary infection after ureteroscopic retrograde intracavitary lithotripsy include preoperative SII, intraoperative sign of infection, and WBC level. Preoperative SII and intraoperative sign of infection both demonstrate high predictive efficacy for postoperative urinary infection, especially preoperative SII.

Key words： Retrograde flexible ureteroscopic intracavitary lithotripsy Urinary infection Systemic immune-inflammation index Sign of infection

基金资助:海南省重点研发计划项目,(编号:ZDYF2017125);联勤保障部队第九二八医院科研项目,(编号:2025YJKT005)

通讯作者: 李威

引用本文:

王凯剑, 黄尉, 李威. 术前系统免疫炎症指数及术中感染迹象在预测输尿管软镜逆行腔内碎石术后尿源性感染中的价值[J]. 河北医学, 2026, 32(2): 247-252.
WANG Kaijian, HUANG Wei, LI Wei. The Value of Preoperative Systemic Immune Inflammatory Markers and Intraoperative Signs of Infection in Predicting Urinary Tract Infections Following Ureteroscopic Retrograde Intraoperative Lithotripsy. HeBei Med, 2026, 32(2): 247-252.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2026.02.011 或 http://www.hbyxzzs.cn/CN/Y2026/V32/I2/247

[1] 邬凌峰,谢文华,陆星尘.老年泌尿系结石术后患者并发尿源性脓毒症的相关危险因素及预防策略[J].中国老年学杂志,2024,44(14):3424-3427.
[2] 岳济,雷超,刘袁林,等.经皮肾镜联合输尿管软镜取石术治疗输尿管结石合并同侧肾结石的效果研究[J].转化医学杂志,2024,13(1):95-100.
[3] 陈嘉敏,徐江浩,王云炎.输尿管结石术后尿源性脓毒症患者外周血IL-17A、PAR和SⅡ表达及其预测价值[J].分子诊断与治疗杂志,2025,17(6):1106-1108,1112.
[4] Huang J,Xie L,Yang Y,et al.Hypoalbuminemia within one hour after surgery as a predictor of post-operative urosepsis in patients undergoing flexible ureteroscopy lithotripsy: a retrospective study[J].Surg Infect (Larchmt), 2023,24(1):75-81.
[5] 张大坤,张洪波,董德鑫,等.上尿路结石行输尿管镜碎石术后尿源性脓毒血症的早期诊治[J].首都医科大学学报,2024,45(5):870-874.
[6] Tan D,Wu F,Huo W.Clinical characteristics and risk factors of systemic inflammatory response syndrome after flexible ureteroscopic lithotripsy[J].Arch Esp Urol, 2022,75(7):618-623.
[7] 李亚.上尿路结石逆行腔内碎石术后尿源性感染危险因素的临床研究[D].吉林:延边大学,2023.
[8] Ding L,Wang X,Deng X,et al.Preoperative systemic immune-inflammation index as a significant prognostic factor after TURBT in patients with non-muscle-invasive bladder cancer:a retrospective study based on propensity score matching analysis[J].Cancer Med, 2023,12(6):7019-7028.
[9] 杜震,崔亮,高瞻,等.铜绿假单胞菌注射液预防女性反复发作尿路感染的多中心、随机对照临床研究[J].中华泌尿外科杂志,2024,45(12):925-931.
[10] 顾燕青,郭宗保,唐新宇,等.输尿管软镜联合可弯曲负压吸引鞘用于感染性肾结石取石术的倾向评分匹配分析[J].中国内镜杂志,2025,31(2):1-8.