尿石症危险因素病例对照研究

Hospital-based case-control study on risk factors for urolithiasis in Shenzhen

目的 探讨尿石症发病危险因素和保护因素 ,为人群预防提供依据。方法 采用基于医院的病例对照研究 ,选取尿石症新发病人并按 1∶ 1配对 ,应用 Foxpro 5 .0建立数据库 ,SPSS 7.5进行数据分析。结果 6 7个因素中 2 2个入选单因素条件 L ogistic回归模型 ,最终进行多因素条件L ogistic回归模型的变量共 12个 ,可划归 5类 ,即社会经济状况、家庭尿石症病史、工作条件、生活和饮食习惯、营养素等。尿石症的危险因素包括家庭年人均收入高 (OR =1.0 2 6 ,OR 95 % CI=1.0 10～ 1.0 4 2 )、一级亲属尿石症病史 (6 .4 2 9,2 .899～ 14 .2 5 5 )、习惯性饮水较少 (1.914 ,1.2 72～2 .881)、口味偏咸 (6 .94 8,2 .12 4～ 2 2 .72 3)、喜吃甜食 (8.4 6 4 ,1.82 1～ 39.337)、高蛋白质 (1.75 2 ,1.4 2 3～ 2 .15 8)、高脂肪 (1.2 36 ,1.0 5 6～ 1.4 4 8)和高磷 (1.380 ,1.184～ 1.6 0 9) ;尿石症发病的保护因素包括日饮水次数较多 (0 .771,0 .6 14～ 0 .96 7)、高碳水化合物 (0 .6 4 0 ,0 .5 31～ 0 .772 )、高膳食纤维 (0 .72 2 ,0 .6 18～ 0 .84 3)和高维生素 C(0 .76 3,0 .6 4 1～ 0 .90 7)。结论 尿石症发病主要受饮食习惯和营养因素影响 。

Objective To explore the inter relationships between urolithiasis and various factors and to determine the potential implications for prevention. Methods With the hospital based case control study, 241 patients with idiopathic urolithiasis were collected as cases and 241 patients without any urinary diseases were selected as controls by 1∶1 match. Results With multivariate Logistic regression analyses, the influencing factors for urinary calculi were dietary intake variables including more intake of protein (OR=1.752,OR95%CI=1.423～2.158), fat ( 1.236 , 1.056 ～ 1.448 ), phosphorus (1.380,1.184～ 1.609 ), carbohydrate ( 0.640 , 0.531 ～ 0.772 ), dietary fibre ( 0.722 , 0.618 ～ 0.843 ) and vitamin C ( 0.763 , 0.641 ～ 0.907 ), and dietary habit variables including drinking less water (1.914,1.272～2.881), salted taste ( 6.948 , 2.899 ～ 14.255 ), and higher family income per capita (OR= 1.026 , 1.010 ～ 1.042 ). Conclusions Dietary habits and nutrition intake are most important factors associated with urolithiasis. The positive family history with urolithiasis and family income increase the risk of urolithiasis.