S.T.O.N.E.评分系统在输尿管结石体外冲击波碎石中的应用价值

Application of the S.T.O.N.E.score in extracorporeal shock wave lithotripsy for patients with ureteral calculi

目的 利用S.T.O.N.E.评分系统预测输尿管结石体外冲击波碎石的清除率,评估其效果及敏感性.方法 S.T.O.N.E.评分系统5个指标可通过泌尿系CT平扫等影像学检查得到：S为结石大小,T结石位于输尿管的位置,O梗阻情况（肾积水情况）,N为结石数目,E结石硬度（CT值）.应用S.T.O.N.E.评分系统对915例行体外碎石的输尿管结石患者进行回顾性评价,通过logistic回归预测模型,绘制ROC曲线,计算曲线下面积（AUC）,评价S.T.O.N.E.评分预测的准确性,并计算敏感度,特异度.结果 结石清除率与S.T.O.N.E.评分呈负相关,评分越高结石清除率越低,S.T.O.N.E.评分AUC为0.955（P＜0.001）.结论 S.T.O.N.E.评分系统预测输尿管结石体外碎石的清除率,敏感性较高,有助于在输尿管结石体外碎石中评估和分析.

Objective To predict clearance of extracorporeal shock wave lithotripsy for patients with ureteral calculi by S.T.O.N.E.Score and to evaluate the effectiveness and sensitivity.Methods The S.T.O.N.E.Score consisted of 5 stone characteristics：（S） ize,（T） opography （location of stone）,（O） bstruction,（N） umber of stones present,and （E） valuation of Hounsfield Units.The S.T.O.N.E.Score was applied to 915 patients with ureteral calculi who underwent extracorporeal shock wave lithotripsy for retrospective evaluation.The ROC curve,the area under the curve （AUC）,and the accuracy of the S.T.O.N.E.score were evaluated by logistic regression model,and the sensitivity and specificity were calculated.Results Stone free rates （SFR） was found to be correlated to S.T.O.N.E.Score.As S.T.O.N.E.Score increased,the SFR decreased with a logical regression trend （P 〈 0.001）.Conclusions The S.T.O.N.E.Score is a novel assessment tool to predict SFR in patients with ureteral calculi who undergo extracorporeal shock wave lithotripsy.The S.T.O.N.E.Score will help to future analysis of the treatment of urolithiasis.