Cystatin C And Interleukin-18 In The Evaluation Of Postoperative Ureteroscopic Holmium Laser Lithotripsy Applied Study Of Early Renal Function Damage

Objective:Explore the clinical application value of urine Cystatin C(Cys C)and Interleukin18(IL-18)in monitoring early renal function injury and predicting postoperative renal function recovery after ureteroscopic holmium laser lithotripsy by dynamically detecting the change rule of urine Cys C and IL-18 in different time periods after ureteroscopic holmium laser lithotripsy.Provide a basis for the selection of biological indicators in urine for the detection of early renal function injury after ureteroscopic holmium laser lithotripsy.Methods:Selecting 91 patients with unilateral upper ureteral stones diagnosed by B ultrasound or CT of urinary system from October 2019 to December 2020 in Baiyun Hospital Affiliated to Guizhou Medical University as the experimental group,including 51 male patients and 40 female patients.Urine samples were collected 2 h before and 2 h,6 h,12 h and 24 h after ureteroscopic holmium laser lithotripsy,The concentrations of Cys C and IL-18 in urine samples were detected by enzyme-linked immunosorbent assay(ELISA),and the changes of Cys C and IL-18 in urine and their correlation with operation time and pump pressure were analyzed.20 healthy people were selected as the control group,including 10 males and 10 females.The concentrations of Cys C and IL-18 in urine were determined as the baseline normal reference values.Spss19.0 software was used for statistical analysis,and the measured values of different time periods were compared and analyzed.Results:There was no significant difference between the concentration of Cysc and IL-18 in urine 2 h before surgery and that in healthy control group(P>0.05).The concentration of Cysc in urine 2 h and 6 h after surgery was higher than that 2 h before surgery and that in control group,with significant difference(P<0.05).The concentration of Cys C began to increase 2 h after operation.The peak concentration in the measured time period was reached at 6 h after surgery,which was significantly different from that in the control group and the experimental group at 2 h before surgery and 2 h after surgery,with statistical significance(P<0.05).Urine Cys C concentration at 12 h after surgery was lower than that at 6 h after surgery,but still higher than that in the control group,and the difference was significant(P < 0.05).The concentration of Cysc in urine 24 h after operation was close to that in control group and 2 h before operation,and there was no significant difference(P>0.05).The concentration of IL-18 in urine began to increase 2 h after surgery,and there was a significant difference compared with that in preoperative 2 h group and control group(P < 0.05).The concentration of IL-18 in urine 6 h after operation was higher than that in control group and experimental group at 2 h before operation and 2 h after operation,and there was significant difference between the results statistically(P<0.05).The concentration of IL-18 in urine at 12 h after surgery was higher than that at 6 h after surgery,and its concentration was the highest value of each test time in the experimental group,and there was a significant difference between the results(P<0.05).The concentration of IL-18 in urine at 24 h after operation was lower than that at 12 h after operation,and there was no significant difference between the concentration of IL-18 in urine at 24 h after operation and that in control group and 2h before operation(P>0.05).The average concentration of Cysc and IL-18 in postoperative urine was positively correlated with the time of operation and the infusion pressure of intraoperative rinsing fluid.Conclusions:1.Conventional ureteroscopic holmium laser lithotripsy has certain reversible damage to the kidney,and the compensatory effect of the kidney can make the renal function recover in a short time.2.Combined detection of Cys C and IL-18 concentration changes in urine has certain diagnostic value for early renal damage after ureteroscopic holmium laser lithotripsy,and provides reference value for clinical monitoring of early renal damage after ureteroscopic lithotripsy.