延边地区100例泌尿系统结石成分分析及代谢评价

Analysis of chemical composition of urinary stones and evaluation of metabolic disturbance in 100 patients with urinary stones of Yanbian area

[目的]了解延边地区泌尿系统结石的化学成分及与尿代谢异常、性别和民族差异性的关系,探讨其在泌尿系统结石预防和治疗中的临床价值.[方法]收集长期居住在延边地区的上尿路结石100例,利用化学试剂方法对其结石中的草酸盐、磷酸盐、尿酸及尿酸盐、胱氨酸、碳酸盐、铵、钙、镁等主要成分进行测定,结合患者临床资料中的尿酸、尿比重、尿pH值、尿钙水平等进行分析.[结果]100例上尿路结石中含有草酸盐成分的为92例(92%),磷酸盐成分为49例(49%),尿酸及尿酸盐为20例(20%),碳酸盐成分为27例(27%),铵成分为13例(13%),钙成分为92例(92%),镁成分为42例(42%),无含有胱氨酸成分结石.100例中含有1种成分的结石为35例(35%),2种成分为44例(44%),3种成分为19例(19%),4种成分为2例(2%).24h尿分析结果示代谢异常为43例(43%),其中高尿酸尿症为13例,高尿比重为21例,pH值低于5.5的为7例,高尿钙症为2例.汉族与朝鲜族泌尿系统结石成分中尿酸及尿酸盐差异明显(P<0.05).[结论]延边地区泌尿系统结石成分以草酸盐和磷酸盐为主;不同尿代谢异常、不同民族及性别人群的生活习惯及饮食方法不同导致结石成分不同.

OBJECTIVE To study the relationship between chemical composition of urinary stones and metabolic disturbance, nation and gender in Yanbian area, and its clinical significance of prevention and treatment for urinary stones. METHODS 100 cases of upper urinary tract stones were selected in permanent residents in Yanbian area, and it was measured from the urinary stones by chemical reagents that the maim composition of phosphate, uric acid and urate, oxalate, carbonate, cystine, ammonium, calcium and magnesium, and it was analyzed with combined with the clinical data of uric acid, urine specific gravity, urine Ph value and urinary calcium. RESULTS Out of upper urinary tract stones, containing the component of oxalate stone was in 91 cases（91%）, of phosphate stone in 49 cases（49%）, of uric stone in 7 cases （21%）, of ammonium storm in 13 cases（13% ）, of calcium stone in 91 cases（91% ）, of magnesium stone in 42 cases （42%） and of cystine stone in no cases （0%）, and containing one composition was in 35 cases（35%）, two components in 44 cases （44%）, three components in 19 cases （19 % ） and four components in 2 cases （2%）. Metabolic disturbance by urinalysis for 24 h was in 43 （43 % ）, in which the hyperuricosuria was in 13 cases, high urine specific gravity in 21 cases, under 5.5 of urine Ph value in 7 cases, and hypercalciuria in 2 cases. The uric acidand urate in components of urinary stones were significant difference between nan nauonanty anu Korean-Chinese（P〈0.05）. CONCLUSION Urinary calculi in Yanbian area is the oxalate and phosphate as primary component, and to determine the calculi ingredient and evaluation of urine metabolism in patients has important clinical significance to understanding the causes of urinary calculi, prevention of lithogenesis and recurrence and setting up the prevention and treatment system for urinary calculi.