549例上尿路结石的化学成分分析及临床意义

Chemical composition of upper urinary tract claculi: An analysis in 549 cases

目的：分析549例上尿路结石成分构成，探讨结石特点和指导尿路结石的治疗。方法：回顾性分析2008年3月～2012年12月间549例尿路结石患者的临床资料，收集其结石标本进行化学成分分析。结果：结石发生人群分布在16～91岁之间，发病高峰年龄段为40～49岁。单一成分结石201例（36．61％），混合性结石348例（63．39％）。结石成分中草酸钙占74．31％，磷酸钙结石占46．99％，磷酸铵镁结石占17．49％，尿酸铵结石占9．84％，尿酸结石占8．20％，碳酸钙结石占4．92％，胱氨酸结石占4．37％。其中含钙90．71％，含磷62．30％，含铵26．23％，含镁18．58％。结论：泌尿系结石成因复杂，术后结石再生复发率较高，结石成分分析对于指导治疗、预防结石复发具有重要的意义。

Objective：To analyze the chemical composition of upper urinary tract stones in 549 cases for the calculus property to plan rationale treatment protocol.Methods：The clinical data were retrospectively analyzed in 549 patients undergone treatment of upper urinary tract calculi in our department be-tween March 2008 and December 2012,and the stone samples were obtained for detection of the chemical components .Results：Prevalence of the upper u-rinary tract stones was seen in from 40 to 90 years of age,yet most frequent between 40 and 49 years.Urinary stones of single component occurred in 201 cases （36.61%） and mixed stones in 348（63.39%）.The causative lithiases were composed of calcium phosphate （74.31%）,ammoniomagnesium phosphate（17.49%）,ammonium urate（9.84%）,uric acid（8.20%）,calcium carbonate（4.92%） or cystine（4.37%）.The most chemical component in the stones was calcium（90.71%）,phosphonium（62.30%）,ammonium（26.23%） or magnesium（18.58%）.Conclusion：Urinary calculus may be associated with complicated causes and has higher incidence of recurrence.Knowledge of the chemical composition of urinary stones helps understanding their etiology,adequate management including prevention and recurrence.