150例泌尿系结石成分定量分析

Quantitative analysis of urinary stone composition in 150 cases

目的:对泌尿系结石成分进行定量分析,为探究尿石成因提供指导及帮助。方法:采用智能结石红外光谱分析仪对150例泌尿系结石进行定量分析,观察不同性别、年龄、结石部位、初发/复发结石间各结石成分相对含量差异是否有统计学意义。结果:结石各晶体成分以一水草酸钙平均相对含量最高(57.44%),其后依次为碳酸磷灰石(18.13%)、二水草酸钙(10.73%)、无水尿酸(8.00%)、六水磷酸铵镁(1.66%)。单一成分结石45例,主要为一水草酸钙(66.67%)、无水尿酸(20.00%)。混合性结石105例,平均相对含量主要为一水草酸钙(53.49%)、碳酸磷灰石(25.90%)、二水草酸钙(15.33%)。不同性别间,草酸钙结石(P=0.027)、磷酸钙结石(P=0.020)、磷酸铵镁结石(P<0.01)平均相对含量差异有统计学意义。不同结石部位间,草酸钙结石(P=0.013)、尿酸结石(P<0.01)平均相对含量差异有统计学意义。60岁以下与60岁以上者,磷酸钙结石(P<0.01)、尿酸结石(P<0.01)平均相对含量差异有统计学意义。初发结石与复发结石平均相对含量差异无统计学意义(P>0.05)。结论:不同性别、年龄、结石部位间,结石成因可能不同。因此,对于不同性别、年龄、部位的结石,可采取针对性的防治措施。

Objective： To quantitatively analyse urinary stone composition so as to offer guidance and assistance for exploring the causes of urinary stones. Method： All 150 cases of urinary stones were quantitatively analysed by Fourier transform infrared （FTIR） spectroscopy. Then we observed whether there were significant differences in statistics of stone composition among different genders, ages, stone position and primary/recurrent stone. Result： The highest average relative content of the crystal component of stones was calcium oxalate monohydrate （57.44%）, then followed by carbonated apatite （18.13%）, calcium oxalate dihydrate （10.73~）, anhydrous uric acid （8.00%）, struvite （1. 66 %）. In 45 cases of single component stones, main component was calcium oxalate monohydrate （66.67%） and anhydrous uric acid （20.00 %）. In 105 cases of mixed calculus, average relative con- tent in sequence was calcium oxalate monohydrate （53.49 %）, carbonated apatite （25.90%） and calcium oxalate dib, ydrate （15.33%）. In different genders, average relative content of calcium oxalate （P =0. 027）, calcium phosphate （ P = 0. 020）, struvite （ P %0. 01）, which showed significant differences in statistics. In different stone position, average relative content of calcium oxalate （ P =0. 013）, uric acid （ P 〈0.01）, which the differ- ences were significant statistically. Patients above or below 60 years old, average relative content of calcium phos- phate （ P %0.01）, uric acid （ P 〈0.01）, which showed significant differences statistically. There was no signifi- cant difference between primary stone and recurrent stone in composition. Conclusion： Causes of stone formation may be distinctive among different genders, ages and stone position, so it can take targeted preventive measures.