微造瘘经皮肾镜吸引取石术后血降钙素原、白介素—6、内毒素鲎变化研究(1)
[摘要]目的 探讨微造瘺经皮肾镜吸引取石术(SMPCNL)后血降钙素原(PCT)、白介素-6(IL-6)、内毒素鲎浓度的变化。方法 将我院2014年7月～2015年7月收治的122例有经皮肾镜取石手术适应证的患者为研究对象，均无手术禁忌证。以患者入院时间奇偶数为依据将患者分为两组，SMPCNL组行SMPCNL，共62例；传统微造瘘经皮肾镜取石(MPCNL)组行MPCNL，无负压吸引，共60例。测定和比较两组患者术前及术后1 d PCT、IL-6、内毒素鲎浓度的变化。结果 SMPCNL组患者术前PCT、IL-6、内毒素鲎值分别为(0.056±0.011)ng/ml、(5.4±3.9)pg/ml、(0.56±0.34)EU/ml，术后1 d分别为(0.336±0.230)ng/ml、(6.9±4.5)pg/ml、(1.68±0.57)EU/ml；MPCNL组患者术前PCT、IL-6、内毒素鲎指标分别为(0.050±0.021)ng/ml、(5.2±4.1)pg/ml、(0.55±0.27)EU/ml，术后1 d分别为(3.652±1.680)ng/ml、(8.9±5.6)pg/ml、(3.27±2.12)EU/ml，两组术前PCT、IL-6、内毒素鲎值比较，差异无统计学意义(P>0.05)；SMPCNL组及MPCNL组术后1 d血清PCT、IL-6、内毒素鲎值均高于术前(P<0.05)；与MPCNL组术后1 d比较，SMPCNL组术后1 d血清PCT、IL-6、内毒素鲎值低，差异有统计学意义(P<0.05)。结论 作为炎症反应指标血清PCT、IL-6、内毒素鲎浓度是监测经皮肾镜取石的良好指标，SMPCNL术后炎症反应低于MPCNL，可推广应用。
[关键词]微造瘘经皮肾镜取石术；降钙素原；白介素-6；内毒素鲎
[中图分类号] R692.4 [文献标识码] A [文章编号] 1674-4721(2016)11(c)-0056-03
[Abstract]Objective To explore the changes of procalcitonin(PCT)，interleukin-6 (IL-6) and endotoxin limulus after suctioning mini-percutaneous nephrolithotomy (SMPCNL).Methods 122 patients with percutaneous nephrolithotomy indications in our hospital from July 2014 to July 2015 were selected as study object，no surgical contraindications.According to odd and even numbers of admission time，patients were divided into two group，patients in SMPCNL group was given SMPCNL，with a total of 62 cases；patients in traditional mini-percutaneous nephrolithotomy (MPCNL) group were given MPCNL，with no negative pressure suction，a total of 60 cases.The levels of PCT，IL and endotoxin limulus were measured and compared before and after operation for 1 day.Results The level of PCT，IL-6 and endotoxin limulus was (0.056±0.011) ng/ml，(5.4±3.9) pg/ml and (0.56±0.34) EU/ml respectively in SMPCNL group before operation，with (0.336±0.230) ng/ml，(6.9±4.5) pg/ml，(1.68±0.57) EU/ml respectively after operation for 1 day；and the levels of PCT，IL-6 and endotoxin limulus was (0.050±0.021) ng/ml，(5.2±4.1) pg/ml，(0.55±0.27) EU/ml respectively in MPCNL group before operation，with (3.652±1.680) ng/ml，(8.9±5.6) pg/ml，(3.27±2.12) EU/ml respectively after operation for 1 day，there was no significant difference in PCT，IL-6 and endotoxin limulus value between two groups before operation(P>0.05)；serum PCT，IL-6，endotoxin limulus values in two groups after operation for 1 day was higher than that before operation (P<0.05)；serum PCT，IL-6 and endotoxin Limulus value in the SMPCNL group after operation for 1 day was lower than that in the MPCNL group after operation for 1 day，and the difference was statistically significant (P<0.05).Conclusion Serum PCT，IL-6 and endotoxin limulus concentration are good indicators for monitoring percutaneous nephrolithotomy as an indicator of inflammatory reaction.Inflammatory response after SMPCNL is lower than that of MPCNL. (杜传策 吴小园 宋乐明)
[关键词]微造瘘经皮肾镜取石术；降钙素原；白介素-6；内毒素鲎
[中图分类号] R692.4 [文献标识码] A [文章编号] 1674-4721(2016)11(c)-0056-03
[Abstract]Objective To explore the changes of procalcitonin(PCT)，interleukin-6 (IL-6) and endotoxin limulus after suctioning mini-percutaneous nephrolithotomy (SMPCNL).Methods 122 patients with percutaneous nephrolithotomy indications in our hospital from July 2014 to July 2015 were selected as study object，no surgical contraindications.According to odd and even numbers of admission time，patients were divided into two group，patients in SMPCNL group was given SMPCNL，with a total of 62 cases；patients in traditional mini-percutaneous nephrolithotomy (MPCNL) group were given MPCNL，with no negative pressure suction，a total of 60 cases.The levels of PCT，IL and endotoxin limulus were measured and compared before and after operation for 1 day.Results The level of PCT，IL-6 and endotoxin limulus was (0.056±0.011) ng/ml，(5.4±3.9) pg/ml and (0.56±0.34) EU/ml respectively in SMPCNL group before operation，with (0.336±0.230) ng/ml，(6.9±4.5) pg/ml，(1.68±0.57) EU/ml respectively after operation for 1 day；and the levels of PCT，IL-6 and endotoxin limulus was (0.050±0.021) ng/ml，(5.2±4.1) pg/ml，(0.55±0.27) EU/ml respectively in MPCNL group before operation，with (3.652±1.680) ng/ml，(8.9±5.6) pg/ml，(3.27±2.12) EU/ml respectively after operation for 1 day，there was no significant difference in PCT，IL-6 and endotoxin limulus value between two groups before operation(P>0.05)；serum PCT，IL-6，endotoxin limulus values in two groups after operation for 1 day was higher than that before operation (P<0.05)；serum PCT，IL-6 and endotoxin Limulus value in the SMPCNL group after operation for 1 day was lower than that in the MPCNL group after operation for 1 day，and the difference was statistically significant (P<0.05).Conclusion Serum PCT，IL-6 and endotoxin limulus concentration are good indicators for monitoring percutaneous nephrolithotomy as an indicator of inflammatory reaction.Inflammatory response after SMPCNL is lower than that of MPCNL. (杜传策 吴小园 宋乐明)