泌尿系统结石症患者尿液电导率的改变

Changes of urine conductivity in patients with urinary stones

目的调查健康人群及泌尿系统结石患者尿液电导率的变化,探讨尿液电导率的临床应用。方法收集健康人群436名,超声多普勒确诊的肾脏、输尿管结石患者348例,使用UF1000i尿沉渣自动分析仪检测尿液电导率。结果健康人群随机尿液电导率呈正态分布;40岁以上人群较40岁及以下人群电导率降低(P<0.001);肾脏、输尿管结石患者电导率均比正常人降低(P<0.001);结石大小不同的人群间电导率无差异;以电导率作为尿路结石的诊断性实验做受试者工作特征(ROC)曲线,其曲线下面积<0.3。结论泌尿系统结石患者尿液电导率下降,而结石大小对电导率变化不构成影响。尿液电导率不能作为泌尿系统结石的诊断性实验,但可以作为筛查实验,结合尿沉渣分析仪的其他检测指标提示临床医生进行超声多普勒检测确诊泌尿系统结石。

Objective To investigate the changes of urine conductivity in healthy subjects and patients with urinary stones and the clinical application of urine conductivity. Methods A total of 436 healthy subjects and 348 patients with kidney and ureter stones diagnosed by ultrasound were enrolled. UF1000i automatic urine sediment analyzer was used to determine urine conductivity. Results Random urine conductivity showed normal distribution in healthy subjects. Urine conductivities of healthy subjects who were older than 40 years old were lower than those of subjects who were 40 years old or younger （P 〈 0.001 ）. Urine conductivities of patients with kidney and ureter stones were lower than those of healthy subjects （P 〈 0. 001 ）. There was no difference in urine conductivities between patients with different-size stones. Receiver operating characteristic （ROC） curves were drawn by making urine conductivity as a diagnostic test of stone disease, and the areas under ROC curves were 〈 0.3. Conclusions Urine conductivities in patients with urinary stones are lower than those in healthy subjects, and the size of urinary stone does not influence the urine conductivity. Urine conductivity can not he used as a diagnostic test of urinary stones, but can be used as a screening experiment to remind doctors doing ultrasound to detect urinary stones combined with the other urine parameters.