eGFR,BUN/SCr对输尿管软镜钬激光碎石术后双J管附壁结石形成的预测价值OA
Predictive value of eGFR and BUN/SCr for encrusted stone formation on double-J stents after ureteroscopic holmium laser lithotripsy
目的 探讨术前肾小球滤过率(eGFR)及血尿素氮/肌酐比值(BUN/SCr)对预测输尿管软镜钬激光碎石术后双J管附壁结石形成的临床价值,以期为临床治疗提供参考.方法 选取2021年11月—2025年9月于成都市第三人民医院行输尿管软镜钬激光碎石术治疗并于术后4周内拔除双J管的305例上尿路结石患者为研究对象.根据术后4周膀胱镜复查结果,将患者分为结石组(存在附壁结石,n=116)与无结石组(无附壁结石,n=189).收集患者一般资料、实验室指标、疾病特征、围术期指标.采用多因素logistic回归、受试者工作特征(ROC)曲线、De-Long检验等对数据进行统计学分析.结果 2组患者eGFR、BUN、SCr、BUN/SCr、C反应蛋白(CRP)、白细胞计数(WBC)比较,差异均有统计学意义(P<0.05),而血红蛋白(HB)、血小板计数(PLT)比较,差异均无统计学意义(P>0.05).2组患者尿蛋白水平、尿结晶情况比较,差异均有统计学意义(P<0.05),而结石类型、结石部位、结石最大直径、尿比重比较,差异均无统计学意义(P>0.05).2组患者术中出血量比较,差异有统计学意义(P<0.05),而手术时间、尿管拔除时间、住院时间比较,差异均无统计学意义(P>0.05).多因素logistic回归分析结果显示:低eGFR、高BUN/SCr、尿蛋白阳性、尿结晶阳性是术后双J管附壁结石形成的独立危险因素(P<0.05).ROC曲线分析结果:eGFR、BUN/SCr预测附壁结石形成的曲线下面积(AUC)为0.688、0.708,eGFR与BUN/SCr联合预测AUC为0.772.结论 输尿管软镜钬激光碎石术后双J管附壁结石形成与eGFR、BUN/SCr、尿蛋白、尿结晶相关,术前检测eGFR、BUN/SCr有助于预测术后附壁结石是否形成.
Objective To investigate the clinical value of preoperative estimated glomerular filtration rate(eGFR)and blood urea nitrogen to serum creatinine ratio(BUN/SCr)in predicting encrusted stone formation on double-J stents after uretero-scopic holmium laser lithotripsy,so as to provide a reference for clinical treatment.Methods A total of 305 patients with upper urinary tract stones who underwent ureteroscopic holmium laser lithotripsy at the Third People's Hospital of Chengdu from November 2021 to September 2025 and had their double-J stents removed within 4 weeks postoperatively were selected as the study participants.According to cystoscopy findings at 4 weeks postoperatively,patients were assigned to a stone group(with encrusted stones,n=116)and a non-stone group(without encrusted stones,n=189).General data,laboratory indicators,disease characteristics,and perioperative parameters were collected.Multivariate logistic regression analysis,re-ceiver operating characteristic(ROC)curves,and De-Long test were used for statistical analysis.Results There were sta-tistically significant differences between the two groups in eGFR,BUN,SCr,BUN/SCr,C-reactive protein,and white blood cell count(P<0.05),while no statistically significant differences were found in hemoglobin and platelet count(P>0.05).Statistically significant differences were also observed in urine protein level and the absence or presence of urine crys-tals(P<0.05),whereas no statistically significant differences were found in stone type,stone location,maximum stone di-ameter,or urine specific gravity(P>0.05).There was a statistically significant difference in intraoperative blood loss be-tween the two groups(P<0.05),but no statistically significant differences were noted in time of operation,urethral cathe-ter removal time,or length of hospital stay(P>0.05).Multivariate logistic regression analysis showed that low eGFR,high BUN/SCr,positive urine protein,and positive urine crystals were independent risk factors for encrusted stone forma-tion on double-J stents postoperatively(P<0.05).ROC curve analysis showed that the area under the curve(AUC)for eGFR and BUN/SCr in predicting encrusted stone formation was 0.688 and 0.708,respectively,and the combined AUC of eGFR and BUN/SCr was 0.772.Conclusion Encrusted stone formation on double-J stents after ureteroscopic holmium la-ser lithotripsy is associated with eGFR,BUN/SCr,urine protein,and urine crystals.Preoperative measurement of eGFR and BUN/SCr may help predict postoperative encrusted stone formation.
廖慧;魏仁波;席翔;曹敏;熊黎强;颜春连;严沁
成都市第三人民医院/西南交通大学附属医院泌尿外科,成都 610031成都市第三人民医院/西南交通大学附属医院泌尿外科,成都 610031成都市第三人民医院/西南交通大学附属医院泌尿外科,成都 610031成都市第三人民医院/西南交通大学附属医院泌尿外科,成都 610031成都市第三人民医院/西南交通大学附属医院泌尿外科,成都 610031成都市第三人民医院/西南交通大学附属医院泌尿外科,成都 610031成都市第三人民医院/西南交通大学附属医院泌尿外科,成都 610031
医药卫生
双J管附壁结石肾小球滤过率尿素氮/肌酐比值输尿管软镜钬激光碎石术
Double-J stentEncrusted stoneGlomerular filtration rateBlood urea nitrogen/creatinine ratioUreteroscopeHolmium laser lithotripsy
《保健医学研究与实践》 2026 (2)
89-95,7
四川省卫生健康委员会科研课题(20PJ212).
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