现代医药卫生2025，Vol.41Issue(8)：1797-1803,7.DOI:10.3969/j.issn.1009-5519.2025.08.005
上尿路结石患者并发尿脓毒血症风险预测
Risk prediction of urinary sepsis in patients with upper urinary tract calculi
摘要
Abstract
Objective To investigate the risk of preoperative urinary sepsis in patients with upper urina-ry tract calculi,with particular attention to the association with nutritional status.Methods From January 2018 to December 2022,a total of 48 patients with upper urinary tract calculi who had preoperative urinary sepsis in the hospital were selected as the urinary sepsis group,and 96 patients with upper urinary tract stones who did not have preoperative urinary sepsis were selected as the non-urinary sepsis group.The medical histo-ry data and auxiliary examination results of the two groups were collected.The data of the two groups were compared between the two groups.The optimal critical values of controlled nutritional status(CONUT)score and prognostic nutritional index(PNI)for predicting the risk of urosepsis were determined by the receiver op-erating characteristic curve,and their predictive value for the risk of urosepsis was analyzed.Univariate and multivariate logistic regression models were used to analyze the independent risk factors of preoperative urina-ry sepsis in patients with upper urinary calculi.Results The maximum stone diameter,urine white blood cell count,serum creatinine,serum albumin,serum prealbumin,CONUT score,urine culture and urine nitrite posi-tive rate in the urinary sepsis group were significantly higher than those in the non-urinary sepsis group,and the PNI was significantly lower than that in the non-urinary sepsis group,the differences were statistically sig-nificant(P<0.05).The critical value of PNI in predicting the risk of urosepsis was 45.70(the area under the ROC curve was 0.926;sensitivity was 0.854;the critical value of specificity was 0.905)and CONUT score was 2.5 points(AUC=0.907;the sensitivity was 0.875;the specificity was 0.830).Positive urine culture,PNI<45.70,and CONUT score greater than or equal to 2.5 points were independent risk factors for preop-erative urinary sepsis in patients with upper urinary tract calculi,and the differences were statistically signifi-cant(P<0.05).Conclusion Malnutrition can increase the risk of preoperative urinary sepsis in patients with upper urinary tract calculi.Early identification and improvement of nutritional status can help prevent urinary sepsis in patients with upper urinary tract calculi.关键词
上尿路结石/尿脓毒血症/营养状态/危险因素Key words
Upper urinary tract calculi/Urinary sepsis/Nutritional status/Risk factors分类
医药卫生引用本文复制引用
唐纳贤,林安龙,杨川,任正举,张唯力..上尿路结石患者并发尿脓毒血症风险预测[J].现代医药卫生,2025,41(8):1797-1803,7.基金项目
重庆市博士后科学基金项目(CSTB2022NSCQ-BHX0675). （CSTB2022NSCQ-BHX0675）
