上海地区尿路结石成分红外光谱分析

Infrared spectroscopy in the analysis of urinary calculi composition in Shanghai

目的分析尿路结石组成成分,探讨其成因及预防复发方法。方法采用傅立叶红外光谱法对1 415例尿路结石患者的结石标本进行成分分析,分析各种成分与性别、年龄及部位间关系。结果 545例(38.5%)为纯结石,以纯草酸钙结石为主,870例(61.5%)为混合结石,以草酸钙与磷酸钙混合结石为主;男性与女性间结石成分的构成比差异无统计学意义(P>0.05);男性年龄>70岁组草酸钙结石比例低于其他各年龄组(P<0.01),磷酸钙结石比例高于年龄>30～40岁组和>40～50岁组(P均<0.05),尿酸结石比例高于其他各年龄组(P<0.01);女性不同年龄组间结石成分比较差异无统计学意义(P>0.05);下尿路结石患者的年龄大于上尿路结石患者(P<0.05),下尿路结石中尿酸及磷酸钙结石比例高于上尿路结石,草酸钙结石比例低于上尿路结石(P<0.05)。结论红外光谱分析是研究结石成分较理想方法之一,可反映结石不同成分及其含量;性别、年龄及结石位置对结石成分有一定影响。

Objective To explore the pathophysiology and the method to prevent recurrence by analyzing the urinary stone composition. Methods Fourier transform infrared spectroscopy （FT-IR） was used to analyze the stone compsition and the relationship with gender and age of the patients and position of stone in 1 415 cases of urinary stone. Results FT-IR evaluation showed that 545 cases（38. 5%） were pure stone, in which calcium oxalate was the most common type, and 870 （61.5%） were mixed stone, in which the most common type was the mixed stone of calcium oxalate and calcium phosphate. There was no significant difference in stone conposition between males and females （P〉 0.05）. In males aged over 70 years, the proportion of calcium oxalate was lower than that in the other age groups （P〈 0.01）, the proportion of calcium phosphate was higher than the patients aged over 30 to 40 years and over 40 to 50 years （P〈0.05）, and the proportion of uric acid was higher than that in the other age groups （P^0.01）. There was no significant difference in the stone composition in different age group in females （P〈0.05）. The patients＇ age of lower urinary tract stone was older than that of upper urinary tract stone （P〈0.05）, and the proportion of uric acid and calcium phosphate were higher and the proportion of calcium oxalate was lower in lower urinary tract than that in upper urinary tract （P〈0.05）. Conclusion FT-IR is an efficient method of stone analysis to reflect the stone composition and content. The gender and age of patients and stone position may influence stone composition.