全身免疫炎症指数联合输尿管远端径比对原发性膀胱输尿管反流患儿早期突破性尿路感染的预测价值

IF 0.9 4区 医学 Q3 SURGERY
Xiangxiang Chen, Weihua Zheng, Xiaoyu Tang, Yan Chen, Fang Chen, Xiujun Yang
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引用次数: 0

摘要

目的:探讨全身免疫炎症指数(SII)联合输尿管远端直径比(UDR)对原发性膀胱输尿管反流(VUR)患儿早期突破性尿路感染(BT-UTI)的预测价值。方法:对上海市儿童医院2021年1月至2023年12月收治的150例VUR患者进行回顾性分析。根据是否发生早期BT-UTI分为早期BT-UTI组(n = 52)和非早期BT-UTI组(n = 98)。采用单因素和二元logistic回归分析确定影响VUR儿童早期BT-UTI的因素。采用Pearson相关分析评估变量间的关系,采用受试者工作特征(receiver operating characteristic, ROC)曲线评估SII联合UDR对VUR患儿早期BT-UTI的预测价值。结果:年龄、性别、体重指数(BMI)、中性粒细胞(NEU)、淋巴细胞(LYM)、红细胞(RBC)、白细胞(WBC)、合并症、住院时间、护理员文化程度比较,差异均无统计学意义(p < 0.05)。两组间反流等级、UDR、SII和血小板(PLT)差异均有统计学意义(p < 0.05)。经Pearson线性相关分析,SII与LYM呈负相关,与PLT、NEU呈正相关(r分别为0.366、0.839);P < 0.05)。UDR与NEU、LYM无关,与PLT呈正相关(r = 0.280, p < 0.05), SII与UDR呈正相关(r = 0.162, p < 0.05)。二元logistic回归分析显示,UDR和SII是影响VUR患儿早期BT-UTI的因素(OR分别为1.171和5.306;95%置信区间(CI)分别为1.099 ~ 1.249和2.841 ~ 9.912;P < 0.05)。组合变量曲线下面积(AUC)为0.832,标准误差为0.032 (95% CI: 0.768 ~ 0.895),约登指数= 0.53,敏感性为90.4%,特异性为62.2%。综合指数的AUC最接近1,表明预测值最高。结论:UDR联合SII对VUR患儿早期BT-UTI具有较高的预测价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictive Value of Systemic Immune-Inflammation Index Combined with Distal Ureteral Diameter Ratio for Early Breakthrough Urinary Tract Infection in Children with Primary Vesicoureteral Reflux.

Aim: To investigate predictive value of the systemic immune-inflammation index (SII) combined with the distal ureteral diameter ratio (UDR) for early breakthrough urinary tract infection (BT-UTI) in children with primary vesicoureteral reflux (VUR).

Methods: A retrospective analysis was conducted on 150 VUR patients admitted to ShangHai Children's Hospital from January 2021 to December 2023. Patients were divided into the early BT-UTI group (n = 52) and the non-earlyBT-UTI group (n = 98) based on whether early BT-UTI occurred. Univariate and binary logistics regression analyses were performed to identify factors influencing early BT-UTI in VUR children. Pearson correlation analysis was used to assess the relationship between variables, and receiver operating characteristic (ROC) curve was employed to evaluate the predictive value of SII combined with UDR for early BT-UTI in VUR children.

Results: Comparisons of age, gender, body mass index (BMI), neutrophils (NEU), lymphocytes (LYM), red blood cells (RBC), white blood cells (WBC), comorbidities, length of hospital stay, and caregiver education level showed no statistically significant differences (p > 0.05). Differences in reflux grade, UDR, SII, and platelets (PLT) between the groups were statistically significant (p < 0.05). According to Pearson linear correlation analysis, SII was negatively correlated with LYM, and positively correlated with PLT and NEU (r = 0.366 and 0.839, respectively; p < 0.05). UDR was unrelated to NEU and LYM, and positively correlated with PLT (r = 0.280, p < 0.05), and SII was positively correlated with UDR (r = 0.162, p < 0.05). Binary logistic regression analysis indicated that UDR and SII were factors influencing early BT-UTI in VUR children (OR = 1.171 and 5.306, respectively; 95% confidence interval (CI) = 1.099-1.249 and 2.841-9.912, respectively; p < 0.05). The combined variables had an area under the curve (AUC) of 0.832 with a standard error of 0.032 (95% CI: 0.768-0.895), Youden index = 0.53, sensitivity of 90.4%, and specificity of 62.2%. The combined index had an AUC closest to 1, indicating the highest predictive value.

Conclusions: UDR combined with SII boasts a high predictive value for early BT-UTI in VUR children.

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来源期刊
CiteScore
0.90
自引率
12.50%
发文量
116
审稿时长
>12 weeks
期刊介绍: Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.
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