【摘要】 目的 基于C反应蛋白/白蛋白（CRP/ALB）、前列腺素E2（PGE2）、转化生长因子-β₁（TGF-β₁）构建良性前列腺增生患者经尿道前列腺等离子剜除术（TUPEP）术后尿路感染预测模型，探讨其对术后尿路感染的预测价值，为临床早期制定干预方案及促进患者术后恢复提供参考。方法 选取2020年4月至2024年2月郑州市第二人民医院收治的61例良性前列腺增生（BPH）术后尿路感染患者作为感染组，236例BPH术后未发生尿路感染患者作为未感染组，比较两组患者的临床资料。采用LASSO-Logistic回归分析BPH患者术后尿路感染的影响因素。采用受试者工作特征曲线（ROC）分析血清炎性因子对BPH患者术后尿路感染的早期预测价值。结果 感染组患者辅助/诱导T淋巴细胞（CD3⁺CD4⁺）、CRP/ALB、PGE2、TGF-β₁水平分别为（2 561.89±583.55）个/μL、4.34±1.19、（1.81±0.45） ng/mL、（14.12±2.46）μg/L，明显高于未感染组的（2 118.42±525.14）个/μL、3.98±1.14、（1.53±0.40） ng/mL、（13.04±2.27）μg/L，辅助/抑制T淋巴细胞比（CD4/CD8）为1.28±0.37，明显低于未感染组的1.64±0.42，差异均有统计学意义（P<0.05）;LASSO-Logistic回归分析结果显示，术前因尿潴留行导尿术、CD3⁺CD4⁺、CD4/CD8、CRP/ALB、PGE2、TGF-β₁均为BPH患者TUPEP术后尿路感染的独立影响因素（P<0.05）；以CRP/ALB、PGE2、TGF-β₁建立联合1模型，以术前因尿潴留行导尿术、CD3⁺CD4⁺、CD4/CD8、CRP/ALB、PGE2、TGF-β₁建立联合2模型，ROC分析结果显示，联合1模型、联合2模型预测BPH患者TUPEP术后尿路感染的AUC分别为0.899、0.927，且联合2模型的AUC大于联合1模型（P<0.05）。结论 术前因尿潴留行导尿术、CD3⁺CD4⁺、CD4/CD8、CRP/ALB、PGE2、TGF-β₁均为BPH患者TUPEP术后尿路感染的独立影响因素，基于CRP/ALB、PGE2、TGF-β₁构建的预测模型对TUPEP术后尿路感染具有预测价值。更多还原

【Abstract】 Objective To develop a predictive model for urinary tract infections（UTIs） after transurethral plasma enucleation of the prostate（TUPEP） in patients with benign prostatic hyperplasia（BPH） based on C-reactive protein/albumin ratio（CRP/ALB）, prostaglandin E2（PGE2）, and transforming growth factor-β₁（TGF-β₁）, and to evaluate its predictive value for postoperative UTIs, providing references for early clinical intervention and promoting postoperative recovery. Methods A total of 61 BPH patients with postoperative UTIs treated at the Second People’s Hospital of Zhengzhou from April 2020 to February 2024 were selected as the infection group, and 236 BPH patients without postoperative UTIs were selected as the non-infection group. Clinical data were compared between the two groups. LASSO-Logistic regression analysis was used to identify influencing factors for postoperative UTIs in BPH patients. Receiver operating characteristic（ROC） curve analysis was employed to evaluate the early predictive value of serum inflammatory factors for postoperative UTIs in BPH patients. Results The infection group had significantly higher levels of helper/induced T lymphocytes（CD3⁺CD4⁺）, CRP/ALB, PGE2, and TGF-β₁ compared to the non-infection group（all P<0.05）:（2 561.89±583.55） cells/μL, 4.34±1.19,（1.81±0.45） ng/mL,（14.12±2.46 μg/L） vs（2 118.42±525.14） cells/μL,3.98±1.14,（1.53±0.40） ng/mL,（13.04±2.27） μg/L, respectively. The helper/suppressor T lymphocyte ratio（CD4/CD8）was significantly lower in the infection group than in the non-infection group:（1.28±0.37） vs（1.64±0.42）, P<0.05. LASSO-Logistic regression analysis showed that preoperative catheterization for urinary retention, CD3⁺CD4⁺, CD4/CD8,CRP/ALB, PGE2, and TGF-β₁ were independent influencing factors for postoperative UTIs after TUPEP in BPH patients（P<0.05）. Two combined models were established: combined model 1 included CRP/ALB, PGE2, and TGF-β₁,while combined model 2 included preoperative catheterization for urinary retention, CD3⁺CD4⁺, CD4/CD8, CRP/ALB,PGE2, and TGF-β₁. ROC analysis revealed that the AUC values for combined model 1 and combined model 2 in predicting postoperative UTIs were 0.899 and 0.927, respectively, with combined model 2 having a significantly higher AUC than combined model 1（P<0.05）. Conclusion Preoperative catheterization due to urinary retention, CD3⁺CD4⁺, CD4/CD8, CRP/ALB, PGE2 and TGF-β₁ are the independent influencing factors of urinary tract infection in BPH patients after TUPEP. The prediction model based on CRP/ALB, PGE2 and TGF-β₁ has certain predictive value for urinary tract infection after TUPEP.更多还原