Analysis of Serum CGRP and s TNFR-Ⅰ Levels in Patients with Nephrolithiasis Surgery and Their Predictive Value for Urinary Tract Infection

XUE Miaoxin; MA Haoxin; ZHANG Fei; REN Wei; YIN Jian

doi:10.3639/i.issn.2095-3097.2025.01.007

Abstract：Objective To investigate the levels of serum calcitonin gene-related peptide(CGRP)and soluble tumor necrosis factor receptor Ⅰ(sTNFR-Ⅰ)in patients with nephrolithiasis undergoing percutaneous nephrolithotomy(PCNL)and their predictive value for urinary tract infection.Methods A total of 215 patients with nephrolithiasis who received PCNL treatment in Shaanxi Provincial People's Hospital from June 2021 to January 2024 were included and divided into a urinary tract infection group(35 cases)and a non-urinary tract infection group(180 cases)according to whether urinary tract infection occurred.Serum levels of CGRP,sTNFR-Ⅰ,tumor necrosis factor α(TNF-α),and interleukin 6(IL-6)were measured by enzyme-linked immunosorbent assay.The correlation between CGRP,sTNFR-Ⅰ and IL-6,TNF-α was analyzed by Pearson correlation.ROC curve analysis was used to evaluate the predictive value of CGRP and sTNFR-Ⅰ for postoperative urinary tract infection.Logistic regression was used to analyze risk factors for urinary tract infection.Results Preoperative urinary tract infection rate,blood glucose level,and postoperative serum sTNFR-Ⅰ,IL-6,TNF-α,CRP,and PCT levels were significantly higher in the infection group than in the non-infection group,while urinary catheter retention time was longer and serum CGRP levels were lower(P<0.05).Pearson analysis showed that sTNFR-Ⅰ was positively correlated with IL-6 and TNF-α,while CGRP was negatively correlated with these cytokines(P<0.05).ROC analysis showed that the area under the curve(AUC)for CRP,PCT,CGRP,sTNFR-Ⅰ,and their combination in predicting postoperative urinary tract infection were 0.877,0.742,0.784,0.828,and 0.953,respectively.The combined AUC was significantly higher than individual markers(Z combined vs CGRP=2.878,P=0.004;Z combined vs sTNFR-Ⅰ=2.789,P=0.005;Z combined vs CRP=2.400,P=0.016;Z combined vs PCT=3.358,P=0.001).Logistic regression analysis identified IL-6,TNF-α,sTNFR-Ⅰ,CGRP,CRP,and PCT as significant risk factors for postoperative urinary tract infection(P<0.05).Conclusion Postoperative urinary tract infection in nephrolithiasis patients is associated with increased sTNFR-Ⅰ and decreased CGRP levels.sTNFR-Ⅰ and CGRP can serve as predictive biomarkers for urinary tract infection in these patients.