维吾尔族小儿尿石症的高危因素分析及探讨

Analyseis of metabolic risk factors for urolithiasis in Uyghur children

目的探讨分析维吾尔族小儿尿石症的代谢性高危因素。方法回顾性分析对比2014年8月至2016年5月在我院住院的尿石症维吾尔族患儿174例（尿石症组）与非尿石症组（泌尿系B型超声未发现泌尿系结石患儿，并且不存在代谢方面的疾病）167例。测定患儿的空腹血液生化、24h尿生化结果，并行结石成分分析，分析两组代谢相关指标差异及结石患儿结石成分特点。结果尿石症组与非尿石症组血液生化结果对比，差异无统计学意义（P〉0．05）。尿石症组24h尿钙水平为（6．71±1．47）mg／kg，非尿石症组为（2．82±1．16）mg／kg，组间比较，差异有统计学意义（P〈0．05）。尿石症组24h尿镁水平为（0．76±0．21）mg／kg，非尿石症组为（2．69±0．59）mg／kg，差异有统计学意义（P〈0．05）。尿石症组枸橼酸尿水平（201．13±80．03）mg／kg，非尿石症组为（521．71±179．08）mg／kg，差异有统计学意义（P〈0．05）。尿石症患儿中有低枸橼酸尿症124例（71％）；高钙尿症96例（55％），其次为低镁尿症42例（24％）。小儿尿石症结石成分主要为草酸钙134例（77％），其次为鸟粪石23例（13％），磷酸钙14例（8％）等。结论低枸橼酸尿症，低镁尿症，高钙尿症是维吾尔族小儿尿石症的主要高危因素。

Objective To explore the metabolic risk factors of urolithiasis in Uyghur children. Methods From August 2014 to May 2016, the clinical data were reviewed for urolithiasis （n = 174） and nonurolithiasis （n = 167）. Blood and urine samples were harvested in the next morning after admission. Blood biochemistry, 24-bour urinary biochemistry and stone composition were measured by automatic biochemical analyzer. Stone composition and metabolic indices were compared between two groups. Results No inter-group difference in blood biodaemistry existed（P〉0. 05）. The levels of 24-hour urea calcium were （6. 71± 1.47） rng/kg in urolithiasis group versus （2. 82 ±1. 16） mg/kg in nonurolithiasis group. There was significant difference in the level of 24-bout urea calcium （P〈0. 05）. The levels of 24- hour urea magnesium were （0. 76±0. 21） mg/kg in urolithiasis group versus （2. 69 ±0. 59） rne,/kg in nonurolithiasis group. There was significant differevce in the level of 24-hour urea magnesium（P〈0. 05）. The levels of 24-hour urea citrate were （201.13±80.03） mg/kg in urolithiasis group and （521.71±179. 08）rng/kg in nonurolithiasis group. There was significant difference in the level of 24-hour urea citrate （P〈0. 05）. The results of urinalysis in urolithiasis group, hylxxfitraturia （n= 124, 71%）, hypercalciuria （n=96, 55%） and hypomagnesiuria （n= 42, 24%）. Stone analysis： Calcium oxalate took the highest incidence （n=134, 77%）, followed by struvite （n=23, 13%） and calcium phosphate （n=14, 8%）. Conclsions Hypocitraturia, hypercalciuria and hypomagnesiuria are three major metabolic risk factors for urolithiasis in Uyghur children.