关键词: 肾结石；软镜碎石术；神经导向因子-1；结缔组织生长因子；肾损伤；预测

Abstract: Objective To explore the predictive value of serum Netrin-1 and connective tissue growth factor (CTGF) for renal injury after flexible ureteroscopic lithotripsy for renal calculi.Methods A total of 104 patients with renal calculi treated in our hospital from March 2020 to March 2022 after flexible ureteroscopic lithotripsy were selected as the research objects,and 98 people who came to our hospital for physical examination during the same period were selected as the control group.According to the inclusion and exclusion criteria of kidney injury,the patients with kidney stones after flexible ureteroscopic lithotripsy were divided into kidney injury group (n=58) and non-kidney injury group (n=46).The levels of serum Netrin-1 and CTGF were detected by enzyme-linked immunosorbent assay (ELISA). Univariate analysis and multiple Logistic regression were used to analyze the influencing factors of kidney injury after ureteral flexible lithotripsy. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum Netrin-1 and CTGF in kidney injury after ureteral flexible lithotripsy.Results The expression levels of Netrin-1 and CTGF in the study group were higher than those in the control group. Serum Netrin-1 and CTGF levels in renal injury group were higher than those in non-renal injury group. Multivariate Logistic regression analysis showed that Netrin-1≥300 ng/L and CTGF≥0.80 ng/L were risk factors for renal injury after ureteral flexible lithotripsy (P<0.05).The AUC of serum Netrin-1 and CTGF in predicting renal injury after ureteral soft lithotripsy were 0.731(95%CI:0.668~0.813) and 0.845(95%CI:0.798~0.892), respectively. The combined forecast AUC was 0.903(95%CI:0.852~0.955).Conclusion The increased expression levels of serum Netrin-1 and CTGF are closely related to kidney injury after ureteral flexible lithotripsy, and can be used as a biological indicator to evaluate early kidney injury after ureteral flexible lithotripsy, and the combination of the two has higher predictive efficacy.

Key words: kidney stones; flexible lithotripsy; neural guidance factor-1; connective tissue growth factor; kidney injury; forecasting