ABSTRACT
[Abstract ] Objective At present, few studies are reported on procalciton (PCT) and endotoxin (ET) in the diagnosis of urosepsis after percutaneous nephrolithotomy ( PCNL) .The purpose of this study was to investigate the clinical value of the detection of serum procalcitonin and endotoxin in the early diagnosis of urosepsis after PCNL . Methods We retrospectively analyzed the clinical data about 427 cases of upper urinary tract stones treated by PCNL , among which urosepsis developed postoperatively in 49 ( the urosepsis group ) and the other 378 non-urosepsis cases served as controls .At 1 day and 2 hours before PCNL , we detected the levels of serum ET and PCT and analyzed the PCT and ET levels and the results of combined detection in the two groups of patients using the ROC curve. Results At 2 hours before surgery , both the levels of PCT and ET were significantly higher in the urosepsis group than in the non-urosepsis controls ([ 5.18 ±4.43 ] vs [ 1.38 ±1.01 ] ng/mL, P<0.01;[50.91 ±35.45] vs [17.86 ±10.78] pg/mL, P<0.01).ROC curve analyses manifested that the areas under the curve (AUC) of PCT and ET were 0.841 ±0.038 and 0.786 ± 0.043, their sensitivities were 79.6%and 71.4%, and their specificities were 78.0%and 70.1%, respectively.The combined de-tection showed the AUC, sensitivity, and specificity to be 0.915 ±0.029, 85.7%, and 86.5%, respectively, all significantly higher than either PCT or ET detection alone (P<0.01). Conclusion The combined detection of PCT and ET can significantly increase the sensitivity and specificity of early diagnosis of urosepsis after PCNL and is superior to either PCT or ET detection alone .