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Diagnostic value of immune indicators and cytokines in sepsis after percutaneous nephrolithotomy (PCNL).
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Jin Yiheng, Li Yamei, Zhang Xiaoyu, Han Bing, Yan Xingshi
Аннотация
BACKGROUND: To analyse the changes in and diagnostic value of immune indicators and cytokines in patients with sepsis after percutaneous nephrolithotomy (PCNL).
METHODS: Clinical information was gathered from 405 patients with calculi who underwent PCNL at our facility between January 2021 and December 2024. The patients were divided into a sepsis group (12 patients) and a non-sepsis group (393 patients) based on whether sepsis occurred after the operation. The levels of CD4+/CD 8 + cells, the neutrophil-to-lymphocyte ratio (NLR), soluble trigger receptor-1 (sTREM-1) in myeloid cells, procalcitonin (PCT), tumour necrosis factor-alpha (TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">α</span>), and interleukin-6 (IL-6) were measured in the two patient groups. The predictive value of the above indicators for sepsis was analysed via receiver operating characteristic (ROC) curves.
RESULTS: The number of patients with staghorn calculi in the sepsis group was greater than that in the nonsepsis group (P< 0.05). The NLR and sTREM-1 levels were greater in the sepsis group than in the nonsepsis group (all P< 0.05), and the CD 4+/CD 8+ ratio was lower in the sepsis group than in the nonsepsis group (P< 0.05). The levels of serum IL-6, TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">α</span> and PCT in the sepsis group were greater than those in the nonsepsis group (all P< 0.05). The area under the curve (AUC) for the combined prediction of sepsis after PCNL by each index was 0.996, with a predictive sensitivity of 91.3% and a specificity of 98.4%.
CONCLUSIONS: The NLR, sTREM-1, IL-6, TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">α</span> and PCT in patients with sepsis after PCNL increased, whereas the CD 4+/CD 8+ ratio decreased. The combined detection of these levels is beneficial for guiding the early clinical prediction of postoperative sepsis in patients undergoing PCNL.
METHODS: Clinical information was gathered from 405 patients with calculi who underwent PCNL at our facility between January 2021 and December 2024. The patients were divided into a sepsis group (12 patients) and a non-sepsis group (393 patients) based on whether sepsis occurred after the operation. The levels of CD4+/CD 8 + cells, the neutrophil-to-lymphocyte ratio (NLR), soluble trigger receptor-1 (sTREM-1) in myeloid cells, procalcitonin (PCT), tumour necrosis factor-alpha (TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">α</span>), and interleukin-6 (IL-6) were measured in the two patient groups. The predictive value of the above indicators for sepsis was analysed via receiver operating characteristic (ROC) curves.
RESULTS: The number of patients with staghorn calculi in the sepsis group was greater than that in the nonsepsis group (P< 0.05). The NLR and sTREM-1 levels were greater in the sepsis group than in the nonsepsis group (all P< 0.05), and the CD 4+/CD 8+ ratio was lower in the sepsis group than in the nonsepsis group (P< 0.05). The levels of serum IL-6, TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">α</span> and PCT in the sepsis group were greater than those in the nonsepsis group (all P< 0.05). The area under the curve (AUC) for the combined prediction of sepsis after PCNL by each index was 0.996, with a predictive sensitivity of 91.3% and a specificity of 98.4%.
CONCLUSIONS: The NLR, sTREM-1, IL-6, TNF-<span style="color: rgb(32, 33, 34); font-family: sans-serif; font-size: 16px; background-color: rgb(248, 249, 250);">α</span> and PCT in patients with sepsis after PCNL increased, whereas the CD 4+/CD 8+ ratio decreased. The combined detection of these levels is beneficial for guiding the early clinical prediction of postoperative sepsis in patients undergoing PCNL.