天津地区泌尿系结石成分分析

Tianjin Urinary Stone Composition Analysis

目的:了解天津地区泌尿系结石化学成分构成。比较上下尿路结石成分的特点,年龄、性别构成比例及城市居住人群与郊区居住人群的尿路结石成分的异同,为泌尿系结石的治疗及预防提供参考。方法:收集天津医科大学第二医院2005年1月-2009年12月门诊体外冲击波碎石后排出和住院患者手术取出的泌尿系结石标本420例,使用红外光谱法进行定量和定性分析。结果:420例泌尿系结石中单纯草酸钙结石占26.4%(111/420),草酸钙+磷酸钙结石占31.4%(132/420),草酸钙+羟基磷灰石结石占17.4%(73/420),尿酸结石占12.4%(52/420),碳酸磷灰石结石占8.8%(37/420),磷酸镁铵结石占3.1%(13/420),胱氨酸结石占0.5%(2/420),磷酸氢钙结石为0,其中含钙结石占75.2%(316/420);尿酸结石比例高于国内文献报道;男女患病比例为2.75∶1,发病高峰在25～65岁之间,老年泌尿系结石的发病率有增加的趋势;上尿路结石占94.5%(397/420),下尿路结石占5.5%(23/420),比例为17.3∶1;郊区下尿路结石所占比例9.0%(12/134)高于市区3.8%(11/286),结石成分无明显差异;5年间结石成分无明显差异。结论:(1)本组含钙结石上尿路比下尿路多,含尿酸结石及磷酸镁铵结石下尿路比上尿路多。(2)尿酸结石所占结石总数百分比高于国内外文献报道。这对于本地区治疗及预防尿石有一定的参考价值。(3)泌尿系结石发病年龄高峰延迟,说明老年泌尿系结石的发病率增加。(4)郊区下尿路结石比例高于市区,考虑与生活条件及医疗水平有关。(5)本地区5年内结石成分构成无明显变化。

Objective：To understand the Tianjin chemical composition of urinary stones.Comparison of upper and lower urinary tract stones stones by the characteristics,age,gender ratio and urban residential and rural populations living in urinary stones by the crowd of the similarities and differences,for the treatment of urinary calculi and prevention of reference.Methods：Second Hospital of Tianjin Medical University,January 2005 to December 2009 after extracorporeal shock wave lithotripsy patient discharge and inpatient surgery for removal of 420 cases of urinary calculi samples using infrared spectrometry for quantitative and qualitative analysis.Results：420 patients with urinary tract stones in calcium oxalate stones accounted for just 26.4%（111/420）,calcium oxalate and calcium phosphate stones account for 31.4%（132/420）,hydroxyapatite ＋ calcium oxalate stones accounted for 17.4%（73/420）,uric acid stones accounted for 12.4%（52/420）,carbonate apatite stones 8.8%（37/420）,magnesium ammonium phosphate stones 3.1%（13/420）,cystine stones 0.5%（2/420）,dicalcium phosphate stones to 0,in which calcium stones accounted for 75.2%（316/420）.Uric acid stones is higher than the national literature.Male and female prevalence ratio of 2.75∶1,the peak incidence between the age of 25~65 years of age,old age the incidence of urinary stones are on the rise.Upper urinary tract stones accounted for 94.5%（397/420）,lower urinary tract stones 5.5%（23/420）,a ratio of 17.3∶1.The proportion of lower urinary tract stones suburbs 9.0%（12/134） than in urban 3.8%（11/286）,no significant difference in stone composition.5 years,no significant difference between the stone composition.Conclusion：（1）The group of upper urinary calcium stone more than the urinary tract,including magnesium ammonium phosphate stones and uric acid stones in lower urinary tract more than the previous.（2）Uric acid stones was higher than the percentage share of the total number of stones reported in the literature.This is the area of urinary stone treatment and prevention of some reference value.（3）The peak age of onset of urinary stones delay,indicating old age the incidence of urinary calculi to increase.（4）Outskirts of the city is higher than the lower urinary tract stones,consider the level of living conditions and medical care.（5）The stone composition in 5 years,no significant changes in composition.