尿石症相关危险因素调查研究

Investigation on the risk factors related to urolithiasis

目的探讨尿石症患者的性别、发病年龄、发病诱因、发病季节等因素与家族史的关系。方法采用问卷调查形式对150例有家族史、520例无家族史尿石症患者及480例健康对照组进行调查研究。结果 (1)一、二级亲属患病率在150例有家族史患者中分别为11.32%(55/486)和1.92%(27/1403),显著高于无家族史者(无家族史患者及健康对照组)的1.37%(23/1682)和0.17%(6/3458),差异均有统计学意义(χ2=1861.772,P<0.001;χ2=4730.517,P<0.001)。(2)有家族史患者中男性发病年龄(28.7±2.2)岁,早于女性(42.6±5.2)岁,差异有统计学意义(t=2.205,P=0.029);无家族史患者中男性发病年龄(36.2±4.7)岁,早于女性(48.1±2.7)岁,差异有统计学意义(t=2.302,P=0.022);有家族史患者的男性发病年龄显著早于无家族史的男性[(28.7±2.2)岁vs(36.2±4.7)岁;t=2.765,P=0.006],而有、无家族史女性患者间发病年龄的比较无统计学差异[(42.6±5.2)岁vs(48.1±2.7)岁;t=0.628,P=0.531]。(3)有无家族史患者间,各季节发病差异无统计学意义(χ2=1.403,P=0.705),但各季节间总病例数比较,夏、秋两季病例数构成比显著高于春、冬两季(χ2=38.997,P<0.001)。(4)饮水少、高蛋白饮食、感染、卧床、饮酒、服药、外伤、代谢异常、尿路异常等9种环境危险因素分别在有无家族史患者间比较均无统计学差异,但在尿石症患者与健康对照组间比较均有统计学差异(P<0.001)。结论尿石症是一种与环境、遗传因素密切相关的疾病。

Objective To investigate the association between urolithiasis patients＇ gender, age, predisposing factors, onset seasons and family history. Methods 150 cases of urolithiasis patients with family history, 520 cases of urolithiasis patients without family history and 480 cases of healthy controls were selected for questionnaire survey. Results（1） The morbidity rates of the first-degree relatives and second-degree relatives in the 150 patients with family history were 11.32%（55/486） and 1.92%（27/1403）, respectively higher than 1.37%（23/1682） and 0.17%（6/3458） of those without family history（patients without family history and the control group）, the differences were all statiscally significant（χ2=1861.772, P0.001;χ2=4730.517, P0.001）.（2） Among the patients with family history, the mean age of morbidity for the males was（28.7±2.2） years, younger than（42.6±5.2） years of the females, the difference was statiscally significant（t=2.205, P=0.029）. Among the patients without family history, the mean age of morbidity for the males was（36.2±4.7）, younger than（48.1±2.7） of the females, the difference was statiscally significant（t=2.302,P=0.022）. The mean age of morbidity for the males with family history was significantly younger than those without family history [（28.7±2.2） vs（36.2±4.7） years;t=2.765, P=0.006], while the difference of females＇ mean age of morbidity between with family history and without it was no statiscally significant [（42.6±5.2） vs（48.1±2.7） years;t=0.628, P=0.531]（3） Among patients with and without family history, difference of morbidity between seasons was no statiscally significant（χ2=1.403, P=0.705）, but comparison of total cases between seasons, constituent ratio of case number in summer and autumn was significantly higher than in spring and winter（χ2=38.997, P0.001）.（4） Environmental risk factors, such as less water, high protein diet, infection, being sickabed, drinking, medication, trauma, metabolic disorders, urinary tract abnormity, etc. have no significant effect on the morbidity respectively between patients with and without family history, while have significant effect on the morbidity respectively between urolithiasis patients and the control group（P0.001）. Conclusions Urolithiasis is a disease that closely related to environmental factors and heredity.