浙江省台州地区1022例泌尿系结石患者结石成分分析

Composition of urinary stones in Taizhou of Zhejiang province

目的 了解浙江省台州地区泌尿系结石成分组成特点.方法 回顾分析浙江省台州医院2013年5月至2016年5月有结石标本的1 022例泌尿系结石患者的临床资料,采用红外光谱分析结石成分.结果 1 022例中,男女比例为2.4：1;平均年龄（53.4±13.6）岁.单纯性结石者占29.3%（299/1 022）,其中最多的单一结石成分为无水尿酸结石,占15.9%（162/1 022）,其次为一水草酸钙,占12.0%（123/1 022）;混合性结石占70.7%（723/1 022）,其中最多的为一水草酸钙＋二水草酸钙＋碳酸磷灰石,占30.9%（316/1 022）;草酸钙结石最多,占58.9%（602/1 022）,尿酸结石占21.8%（223/1 022）.尿酸结石的男性比例高于女性[18.7%（191/1 022）与3.1%（32/1 022）,χ2=30.97,P=0.00],而感染性结石的女性比例高于男性[8.8%（90/1 022）与9.9%（101/1 022）χ2=60.69,P=0.00];尿酸结石患者的平均年龄为（59.4±12.3）岁,大于其他结石成分患者[（51.7±13.5）岁;t=7.62,P=0.00];感染性结石平均年龄在（49.1±13.7）岁,小于其他结石成分的患者[（54.4±13.3）岁;t=4.87,P=0.00].含草酸钙、尿酸结石在上尿路结石中的比例[53.1%（544/1 022）和15.9%（162/1 022）]高于下尿路结石[5.7%（58/1 022）和5.9%（60/1 022）,χ2=19.60,P=0.00;χ2=42.97,P=0.00].结论 泌尿系结石以混合型结石为主,一水草酸钙＋二水草酸钙＋碳酸磷灰石最多;单纯性结石中尿酸结石最常见.性别、年龄和部位可能与结石成分有关.

Objective To analyze the composition of urinary stones in Taizhou of Zhejiang province.Methods Clinical data of 1 022 patients with urinary stones admitted in Taizhou Hospital of Zhejiang province were retrospectively reviewed.The samples of urinary stones were collected and analyzed by infrared spectrophotometry.Results There were 722 males and 300 females with a male to female ratio of 2.4：1 and with a mean age of （53.4±13.6） years （14-88 years）.Among 1 022 patients,the stones with single composition were found in 299 cases （29.3%）;the most common single-component was anhydrous uric acid （15.9%）,followed by calcium oxalate monohydrate （12.0%）.The mixed stones were found in 723 cases （70.7%）;the most common mixture was calcium oxalate monohydrate,calcium oxalate dehydrate and carbonate apatite mixture （316 cases,30.9%）.Calcium oxalate （58.9%,602/1 022） was the most common major component and frequently seen in upper urinary tract stones,followed by uric acid （21.8%,223/1 022）.Uric acid calculi was predominant component in male patients（χ2=30.97,P=0.00）,while the rate of infection stones was higher in women （χ2=60.69,P=0.00）.The mean age of patients with uric acid stones was 59.4 years,which was older than that with other components （t=7.62,P=0.00）.The uric acid stones were more common in upper urinary tract stones（χ2=42.97,P=0.00）.The mean age of patients with infection stones was 49 years,which was younger than that with other types of stones（t=4.87,P=0.00）.Conclusion Mixed stones with calcium oxalate monohydrate,calcium oxalate dehydrate and carbonate apatite are the predominant urinary stones in Taizhou of Zhejiang province,while the most common single-component stones are anhydrous uric acid stones.Location,age and sex are associated with the types of urinary stones.