目的 探讨诱导型一氧化氮合酶（iNOS）、铜蓝蛋白（CER）及Nod样受体蛋白3（NLRP3）/白细胞介素-1β（IL-1β）信号通路与膀胱癌术后尿路感染的关系。 方法 选取2020年8月至2025年8月山东第一医科大学附属人民医院收治的102例膀胱癌术后尿路感染患者作为尿路感染组，同期选取膀胱癌术后无尿路感染患者102例作为无尿路感染组。分析膀胱癌术后尿路感染患者病原菌分布，比较两组临床资料、iNOS、CER及NLRP3/IL-1β信号通路，予以多因素logistic回归分析法分析膀胱癌术后尿路感染的影响因素，并采用受试者工作特征（ROC）曲线分析血清iNOS、CER及NLRP3/IL-1β信号通路对膀胱癌术后尿路感染的评估价值。 结果 102例膀胱癌术后尿路感染患者共培养出128株病原菌，占比较高的主要为大肠埃希菌和肺炎克雷伯菌，占比分别为37.50%、17.97%。尿路感染组年龄高于无尿路感染组，合并高血压、合并糖尿病、肿瘤分期为Ⅲ期/Ⅳ期、手术时间> 360 min、术后留置导管时间> 7 d的患者占比均高于无尿路感染组（P < 0.05）。尿路感染组血清iNOS、CER、IL-1β、外周血NLRP3水平均高于无尿路感染组（P < 0.05）。多因素logistic回归分析结果显示，年龄偏高、合并糖尿病、手术时间> 360 min、术后留置导管时间> 7 d、血清iNOS水平偏高、血清CER水平偏高、外周血NLRP3 mRNA表达偏高、血清IL-1β水平偏高是膀胱癌术后尿路感染的独立危险因素（OR = 1.881、4.773、1.458、6.322、3.640、2.442、1.594、3.677，P < 0.05）。将尿路感染组纳入阳性，无尿路感染组纳入阴性，血清iNOS、CER及NLRP3/IL-1β信号通路及联合检测评估膀胱癌术后尿路感染的曲线下面积（AUC）分别为0.713、0.736、0.753、0.747、0.939，其中联合检测的AUC最高（P < 0.05）。 结论 大肠埃希菌和肺炎克雷伯菌为膀胱癌术后尿路感染患者主要感染的病原菌，年龄偏高、合并糖尿病、手术时间> 360 min、术后留置导管时间> 7 d、血清iNOS水平偏高、血清CER水平偏高、外周血NLRP3 mRNA表达偏高、血清IL-1β水平偏高是膀胱癌术后尿路感染的独立影响因素，血清iNOS、CER及NLRP3/IL-1β信号通路联合对膀胱癌术后尿路感染具有较高评估价值。

Objective To investigate the relationship between inducible nitric oxide synthase （iNOS）， ceruloplasmin （CER）， and the Nod-like receptor protein 3 （NLRP3）/interleukin-1β （IL-1β） signaling pathway and urinary tract infection after bladder cancer surgery. Methods From August 2020 to August 2025， 102 patients who developed urinary tract infection after bladder cancer surgery and were admitted to the People's Hospital Affiliated to Shandong First Medical University were selected as the urinary tract infection group. Meanwhile， 102 patients who did not develop urinary tract infection after bladder cancer surgery during the same period were selected as the non-urinary tract infection group. The distribution of pathogenic bacteria in patients with urinary tract infection after bladder cancer surgery was analyzed. The clinical data， iNOS， CER， and the NLRP3/IL-1β signaling pathway were compared between the two groups. The influencing factors of urinary tract infection after bladder cancer surgery were analyzed using multivariate logistic regression analysis. The evaluation value of serum iNOS， CER， and the NLRP3/IL-1β signaling pathway for urinary tract infection after bladder cancer surgery was analyzed by the receiver operating characteristic （ROC） curve. Results A total of 128 strains of pathogenic bacteria were cultured from 102 patients with urinary tract infection following bladder cancer surgery. Escherichia coli and Klebsiella pneumoniae accounted for 37.50% and 17.97% respectively. The age of the urinary tract infection group was greater than that of the non-urinary tract infection group. Moreover， the proportion of patients with hypertension， diabetes， tumor stage Ⅲ/Ⅳ， operation duration > 360 min， and postoperative indwelling catheter time > 7 d was higher in the urinary tract infection group than in the non-urinary tract infection group （P < 0.05）. The levels of serum iNOS， CER， IL-1β， and peripheral blood NLRP3 in patients with urinary tract infection were higher than those in patients without urinary tract infection （P < 0.05）. Multivariate logistic regression analysis indicated that advanced age， diabetes mellitus， operation duration > 360 min， postoperative indwelling catheter time > 7 d， elevated serum iNOS level， elevated serum CER level， increased peripheral blood NLRP3 mRNA expression， and elevated serum IL-1β level were independent influencing factors of urinary tract infection after bladder cancer surgery （OR = 1.881， 4.773， 1.458， 6.322， 3.640， 2.442， 1.594， 3.677， P < 0.05）. The urinary tract infection group was considered as positive， while the non-urinary tract infection group was considered as negative. The areas under the curve （AUC） of serum iNOS， CER， NLRP3/IL-1β signaling pathway， and combined detection for evaluating urinary tract infection after bladder cancer surgery were 0.713， 0.736， 0.753， 0.747， and 0.939 respectively， and the AUC of combined detection was the highest （P < 0.05）. Conclusions Escherichia coli and Klebsiella pneumoniae were identified as the primary pathogens responsible for urinary tract infections following bladder cancer surgery. Advanced age， diabetes， an operation duration exceeding 360 minutes， a postoperative indwelling catheter time longer than 7 days， elevated serum iNOS levels， high serum CER levels， increased peripheral blood NLRP3 mRNA expression， and elevated serum IL-1β levels were determined to be independent influencing factors for urinary tract infections after bladder cancer surgery. The combination of serum iNOS， CER， and the NLRP3/IL-1β signaling pathway exhibited high evaluation value for urinary tract infections after bladder cancer surgery.