良性前列腺增生合并非酒精性脂肪性肝病术后尿路感染的影响因素分析

Influencing factors of postoperative urinary tract infection in benign prostatic hyperplasia patients complicated with non-alcoholic fatty liver disease

  • 摘要: 目的探讨良性前列腺增生(BPH)合并非酒精性脂肪性肝病(NAFLD)发生术后尿路感染的影响因素。方法回顾性分析2020年1月至2024年3月武汉科技大学附属孝感医院收治的159例BPH合并NAFLD患者,根据术后是否发生尿路感染分为感染组(n = 48)与非感染组(n = 111),分析尿路感染的影响因素。结果手术时间>1 hOR(95%CI)为3.492(1.257,9.697)、糖尿病史OR(95%CI)为3.073(1.075,8.783)、术后留置导尿管时间>7 dOR(95%CI)为3.121(1.093,8.911)、前列腺质量>50 gOR(95%CI)为3.209(1.203,8.562)、肝功能异常OR(95%CI)为2.616(1.126,7.569)、系统免疫炎症指数SII,OR(95%CI)为1.005(1.002,1.007)、血清淀粉样蛋白ASAA,OR(95%CI)为1.014(1.001,1.028)是BPH合并NAFLD术后尿路感染的危险因素(P均<0.05),预后营养指数PNI,OR(95%CI)为0.968(0.949,0.987)是保护因素,而高血压史、年龄、体质量指数、最大尿流率(Qmax)、住院时间以及甘油三酯与感染无关(P均> 0.05)。根据上述结果建立预测模型,该模型的ROC曲线下面积为0.898(95%CI 0.849~0.947,P < 0.001),灵敏度为0.854,特异度为0.793,阳性预测值为0.641,阴性预测值为0.926。结论手术时间、糖尿病史、术后留置导尿管时间、前列腺质量、肝功能异常、SII、SAA及PNI是BPH合并NAFLD发生术后尿路感染的影响因素,基于上述因素构建的预测模型具有一定的预测价值。

     

    Abstract: ObjectiveTo investigate the influencing factors of postoperative urinary tract infection in benign prostatic hyperplasia (BPH) patients complicated with non-alcoholic fatty liver disease (NAFLD). MethodsClinical data of 159 BPH patients complicated with NAFLD admitted to Xiaogan Hospital affiliated to Wuhan University of Science and Technology from January 2020 to March 2024 were retrospectively analyzed. All patients were divided into the infection (n = 48) and non-infection groups (n =111) according to the occurrence of urinary tract infection. Logistic regression analysis was used to analyze the influencing factors of urinary tract infection. ResultsOperation time>1 h OR(95%CI)=3.492 (1.257,9.697), history of diabetes mellitus OR(95%CI)=3.073 (1.075, 8.783), time of indwelling catheter after operation>7 days OR(95%CI)=3.121 (1.093,8.911), prostate weight>50 g OR(95%CI)=3.209 (1.203,8.562), abnormal liver function OR(95%CI)=2.616 (1.126,7.569), systemic inflammatory index SII, OR(95%CI)=1.005 (1.002,1.007) and serum amyloid ASAA, OR(95%CI)=1.014 (1.001,1.028) were the independent influencing factors for postoperative urinary tract infection in BPH complicated with NAFLD (all P < 0.05). Prognostic nutritional index PNI, OR(95%CI)=0.968 (0.949,0.987) was an independent protective factor for postoperative urinary tract infection (P < 0.05). There were no significant differences in the history of hypertension, age, body mass index (BMI), maximum urinary flow rate (Qmax), length of hospital stay and triglyceride (all P > 0.05). According to the results of multivariate Logistic regression analysis, a prediction model for postoperative urinary tract infection in BPH complicated with NAFLD was established. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.898 (95%CI: 0.849-0.947, P < 0.001), the specificity was calculated as 0.793, the sensitivity was 0.854, the positive predictive value was 0.641 and the negative predictive value was 0.926, respectively. ConclusionsOperation time, history of diabetes mellitus, postoperative indwelling catheter time, prostate weight, abnormal liver function, SII, SAA and PNI are the influencing factors of postoperative urinary tract infection in BPH complicated with NAFLD. This prediction model based on these influencing factors has certain predictive value.

     

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