Diagnostic value of inflammatory mediators profile combined with procalcitonin in urogenic sepsis

doi:10.3877/cma.j.issn.1674-3253.2023.05.010

Abstract

Abstract:

Objective

To assess the diagnostic value of inflammatory mediator profile combined with procalcitonin in the perioperative period of ureteric stones complicated by urogenic sepsis.

Methods

Clinical data of 160 patients with ureteral stones who underwent inflammatory cytokine kit testing admitted to Hunan Provincial People's Hospital between June 2017 and June 2022 were collected, 66 patients in the study group (patients with ureteral stones who developed urogenic sepsis after surgery) and 94 patients in the control group (patients who did not develop urogenic sepsis after ureteral stones). The differences in clinical data and perioperative biochemical indexes between the two groups were analyzed, and the risk factors causing urogenic sepsis were analyzed by multifactorial logistic regression.

Results

The preoperative plasma indices of IL-4, IL-6, IL-10, TFN-α, IFN-γ, CRP, and PCT in the study group were significantly higher than those in the control group, with significant differences between the two groups (P<0.05); the postoperative plasma indices of inflammatory mediator profile, CRP, and PCT in the study group were higher than those in the control group, with significant differences between the two groups (P<0.05). Multi-factor logistic regression analysis showed that elevated preoperative PCT and IL-6 were risk factors for ureteric sepsis after ureterolithotomy.

Conclusions

IL-6 and PCT were significant predictors of urogenic sepsis that would occur after ureteral stone surgery.

Key words: Inflammatory mediators spectrum, Procalcitonin, Urogenic sepsis, Ureteral calculi

Xuecheng Wu, Yuanwei Li, Wuxiong Yuan, Jiansong Wang, Yongzhong Shi, Qiang Lu, Zhuo Li, Jia Chen, Zhe Liu, Yili Teng, Zhiyong Gao. Diagnostic value of inflammatory mediators profile combined with procalcitonin in urogenic sepsis[J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(05): 476-480.

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References 25

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指标	术前		Z值	P值	术后		Z值	P值
指标	对照组(n=94)	研究组(n=66)	Z值	P值	对照组(n=94)	研究组(n=66)	Z值	P值
IL-2(ng/L)	0.09(0.01，0.55)	0.01(0.01，5.45)	-0.562	0.574	1.79(0.23，8.07)^#	10.75(3.40，14.65)^#	-2.214	0.027^*
IL-4(ng/L)	0.36(0.01，1.35)	0.62(0.34，8.65)	-2.868	0.004^*	2.86(0.36，14.54)^#	13.09(7.83，22.40)^#	-2.406	0.016^*
IL-6(ng/L)	2.85(1.36，16.35)	35.17(19.86，66.44)	-2.128	0.036^*	18.68(7.72，54.93)^#	227.30(62.74，560.62)^#	-5.124	<0.001^*
IL-10(ng/L)	2.11(1.43，4.01)	4.23(2.27，9.18)	-2.762	0.006^*	6.37(2.19，14.10)^#	14.22(10.12，61.52)^#	-3.929	<0.001^*
TNF-α(ng/L)	0.03(0.01，1.51)	1.77(0.48，3.74)	-2.879	0.004^*	1.56(0.27，5.67)^#	6.70(3.65，14.18)^#	-3.036	0.002^*
IFN-γ(ng/L)	0.46(0.01，1.22)	0.86(0.44，9.02)	-2.636	0.008^*	2.85(0.58，20.01)^#	22.21(6.36，48.37)^#	-3.018	0.003^*
CRP(mg/L)	3.13(3.13，17.80)	16.00(5.00，79.45)	-2.681	0.007^*	12.40(4.44，53.25)^#	93.00(36.50，142.00)^#	-4.457	<0.001^*
PCT(ng/mL)	0.05(0.05，0.09)	0.28(0.05，1.17)	-2.966	0.003^*	0.12(0.05，0.66)^#	1.99(1.25，20.50)^#	-6.371	<0.001^*

指标	术前		Z值	P值	术后		Z值	P值
指标	对照组(n=94)	研究组(n=66)	Z值	P值	对照组(n=94)	研究组(n=66)	Z值	P值
IL-2(ng/L)	0.09(0.01，0.55)	0.01(0.01，5.45)	-0.562	0.574	1.79(0.23，8.07)^#	10.75(3.40，14.65)^#	-2.214	0.027^*
IL-4(ng/L)	0.36(0.01，1.35)	0.62(0.34，8.65)	-2.868	0.004^*	2.86(0.36，14.54)^#	13.09(7.83，22.40)^#	-2.406	0.016^*
IL-6(ng/L)	2.85(1.36，16.35)	35.17(19.86，66.44)	-2.128	0.036^*	18.68(7.72，54.93)^#	227.30(62.74，560.62)^#	-5.124	<0.001^*
IL-10(ng/L)	2.11(1.43，4.01)	4.23(2.27，9.18)	-2.762	0.006^*	6.37(2.19，14.10)^#	14.22(10.12，61.52)^#	-3.929	<0.001^*
TNF-α(ng/L)	0.03(0.01，1.51)	1.77(0.48，3.74)	-2.879	0.004^*	1.56(0.27，5.67)^#	6.70(3.65，14.18)^#	-3.036	0.002^*
IFN-γ(ng/L)	0.46(0.01，1.22)	0.86(0.44，9.02)	-2.636	0.008^*	2.85(0.58，20.01)^#	22.21(6.36，48.37)^#	-3.018	0.003^*
CRP(mg/L)	3.13(3.13，17.80)	16.00(5.00，79.45)	-2.681	0.007^*	12.40(4.44，53.25)^#	93.00(36.50，142.00)^#	-4.457	<0.001^*
PCT(ng/mL)	0.05(0.05，0.09)	0.28(0.05，1.17)	-2.966	0.003^*	0.12(0.05，0.66)^#	1.99(1.25，20.50)^#	-6.371	<0.001^*

术前指标	B值	S.E	Wald	P值	OR值	95%CI
PCT	0.125	0.059	4.554	0.033	1.133	0.760~1.210
IL-6	0.095	0.013	4.474	0.034	1.100	1.011~1.148

术前指标	B值	S.E	Wald	P值	OR值	95%CI
PCT	0.125	0.059	4.554	0.033	1.133	0.760~1.210
IL-6	0.095	0.013	4.474	0.034	1.100	1.011~1.148

指标	AUC	标准误	P值	95%CI	截断值
术前IL-6	0.9190	0.0347	<0.001	0.820~0.972	29.357
术前降钙素原	0.8460	0.0491	<0.001	0.736~0.936	0.238
联合检测	0.9214	0.0500	<0.001	0.901~0.986	-

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