摘要目的:探究白蛋白/球蛋白比值(A/G比值)和单核细胞人类白细胞DR抗原(HLA-DR)与泌尿系结石术后全身炎症反应的相关性。方法:选取2021年8月至2023年2月在本院行泌尿系统结石手术的95例患者为研究对象，根据患者术后是否出现全身炎症反应将患者分为发生组(31例)和未发生组(64例)。收集两组患者的临床资料和实验室指标，采用多因素logistic回归分析影响患者发生全身炎症反应的相关因素，并采用受试者工作特征(ROC)曲线分析患者的A/G比值和HLA-DR对患者术后发生全身炎症反应的预测价值。结果:发生组和未发生组患者的年龄、性别、体质量指数(BMI)、结石侧别、高血压、结石手术史、美国麻醉师协会(ASA)评分及结石数量比较，差异均无统计学意义(均 P>0.05)；发生组患者的尿培养阳性、糖尿病、术后结石残留及尿白细胞阳性发生率均高于未发生组(均 P<0.05)。与未发生组患者相比较，发生组患者的白细胞计数、中性粒细胞计数、HLA-DR水平均升高，A/G比值及淋巴细胞计数水平降低(均 P<0.05)。多因素logistic回归分析结果显示，白细胞计数、A/G比值、HLA-DR、中性粒细胞计数、淋巴细胞计数、尿白细胞均是结石患者术后并发全身炎症反应的影响因素(均 P<0.05)。ROC曲线分析结果显示，A/G比值、HLA-DR预测患者术后并发全身炎症反应的曲线下面积(AUC)分别为0.791、0.834。 结论:A/G比值和HLA-DR与泌尿系结石患者术后发生全身炎症反应存在相关性，存在全身炎症反应的泌尿系结石患者的A/G比值降低，HLA-DR升高，二者对患者术后并发全身炎症反应存在较高的预测价值。

abstractsObjective:To explore the relationship between albumin/globulin ratio (A/G ratio) and monocyte human leukocyte antigen-DR (HLA-DR) and systemic inflammatory response after urinary calculi operation.Methods:Ninety-five patients who underwent urolithiasis surgery in our hospital from August 2021 to February 2023 were selected as the study objects, and the patients were divided into the occurrence group (31 cases) and the non-occurrence group (64 cases) according to whether there was systemic inflammatory response after surgery. Clinical data and laboratory indicators of the two groups of patients were collected. Multivariate logistic regression analysis was used to explore the factors affecting the occurrence of systemic inflammatory response in patients, and receiver operating characteristics (ROC) curve was used to analyze the predictive value of patients′A/G ratio and HLA-DR on postoperative systemic inflammatory response.Results:There were no significant differences between the two groups in terms of age, sex, body mass index (BMI), lithiasis side, hypertension, history of lithiasis surgery, American Society of Anesthesiologists (ASA) score, and number of stones (all P>0.05). However, the occurrence group exhibited higher incidence rates of positive urine culture, diabetes, postoperative stone residue, and positive urine white blood cells compared to the non-occurrence group (all P<0.05). Additionally, the occurrence group showed increased leukocyte count, neutrophil count, and HLA-DR levels, while the A/G ratio and lymphocyte count were lower compared to the non-occurrence group (all P<0.05). Multivariate logistic regression analysis showed that white blood cell count, A/G ratio, HLA-DR, neutrophil count, lymphocyte count and urinary white blood cell were all influential factors of postoperative systemic inflammatory response in patients with calculus ( P<0.05). ROC curve analysis results showed that the area under the curve (AUC) of A/G ratio and HLA-DR in predicting postoperative inflammatory response were 0.791 and 0.834, respectively. Conclusions:The A/G ratio and HLA-DR expression levels are significantly associated with the postoperative systemic inflammatory response in patients with urinary calculi. Specifically, in patients exhibiting a systemic inflammatory response, a decreased A/G ratio and increased HLA-DR expression demonstrate high predictive value for the occurrence of postoperative systemic inflammation.