血清Flt3L、Tim-4对泌尿系统结石患者输尿管软镜碎石术后发生SIRS的预测价值OA

Objective To analyze the serum Fms-like tyrosine kinase 3 ligand(Flt3L)and T-cell immuno-globulin and mucin domain-containing molecule 4(Tim-4)levels before flexible ureteroscopic lithotripsy(FURL)in the patients with urinary calculi and their predictive value for the occurrence of postoperative sys-temic inflammatory response syndrome(SIRS).Methods A total of 145 patients with urinary calculi who un-derwent FURL in this hospital from August 2020 to June 2022 were selected as the calculus group.According to whether SIRS occurred within postoperative 48 h,the patients were divided into the SIRS group and non-SIRS group.Eighty healthy volunteers who underwent physical examinations in this hospital during the same period were selected as the control group.The serum Flt3L and Tim-4 levels were compared among the groups.The multivariate Logistic regression was used to analyze the influencing factors of SIRS occurrence af-ter FURL in the patients with urinary calculi.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficiency of serum Flt3L and Tim-4 for the occurrence of SIRS after FURL in the pa-tients with urinary calculi.Results The serum Flt3L and Tim-4 levels in the calculus group were higher than those in the control group(P<0.05).Compared with the non-SIRS group,the operation time of the SIRS group was prolonged,and the proportion of the patients with preoperative positive midstream urine bacterial culture was increased,and the differences were statistically significant(P<0.05).The serum Flt3L and Tim-4 levels in the SIRS group were significantly higher than those in the non-SIRS group(P<0.05).The multi-variate Logistic regression analysis results showed that the prolonged operation time,preoperative midstream urine bacterial culture positive and increased serum Flt3L and Tim-4 levels were the risk factors for the SIRS occurrence after FURL in the patients with urinary calculi(P<0.05).The areas under the curves(AUCs)of serum Flt3L and Tim-4 alone and their combination for predicting the SIRS occurrence after FURL in the pa-tients with urinary calculi were 0.837,0.842 and 0.936,respectively.The AUC of the 2-item combination pre-diction was greater than that of serum Flt3L(Z=2.079,P=0.038)and Tim-4(Z=2.006,P=0.045)a-lone.Conclusion The serum Flt3L and Tim-4 levels in the urinary calculi patients with SIRS occurrence after FURL are significantly elevated.The 2-item indicators have certain value in predicting the SIRS occurrence after FURL in the patients with urinary calculi,moreover the predictive efficiency of the 2-item combination is higher.