社区复杂性肾结石患者24小时尿液成分分析

Analysis of 24-hour urine component in community patients with complex renal calculi

目的探讨分析社区复杂性肾结石患者24 h尿液成分,以便更好地预防和治疗结石,减少结石复发。方法选取各社区年龄大于18岁,尿量大于400 m L,非慢性肾功能不全的112例复杂性肾结石患者,行24 h尿液成分分析,记录24 h总尿量,运用全自动生化分析仪检测分析尿钙、尿尿酸、尿镁、尿磷、尿钠、尿钾、尿肌酐等情况,运用离子色谱仪对尿草酸、尿枸橼酸进行检测。结果 112例结石患者中有107例(95.6%)存在代谢异常,其中低尿量48例(44.9%),高钙尿21例(19.6%),低镁尿61例(57.0%),高钠尿38例(35.5%),高磷尿42(39.3%),高尿酸尿25例(23.4%)。由于设备情况,枸橼酸和草酸有9例未检测,高草酸尿36例(33.6%)、低枸橼酸尿82例(76.6%)。107例结石患者中单纯一种代谢异常11例(10.2%);同时合并两种代谢异常35例(32.7%);同时合并三种代谢异常44例(43.1%);同时合并四种代谢异常14例(13.1%);四种以上有3例(2.80%)。结论广州市各社区复杂性肾结石居民中大多数存在代谢异常情况,对复杂性肾结石居民或存在结石复发危险因素居民均应进行24 h尿液成分分析,进行全面的代谢评估,以便有效的预防和治疗结石。

ObjectiveTo analyze of 24-hour urine component in community patients with complex renal calculi,thereby to better prevent, treat calculi and reduce the recurrent of calculi. MethodsA total of 112 complex renal calculi patients without chronic renal insufficiency （〉18 years of age, urine volume〉400 mL）were enrolled. Then 24-hour urine component was analyzed, and 24-hour urine volume was recorded. Automatic biochemical analyzer was used to detect the levels of urinary calcium, uric acid, magnesium, phosphorus, sodium, potassium and creatinine. Ion chromatography was used to detect the levels of urine oxalate and citrate. ResultsOf 107 patients with calculi, metabolic disturbance was found in 112 cases （95.6%） including 48 cases （44.9%） with reduced urine volume, 21 cases（19.6%） with hypercalciuria, 61 cases （57.0%） with hypomagnesiuria, 38 cases（35.5%） with hypernatriuria, 42 cases （39.3%） with hyperphophauria, 25 cases （23.4%） with hyperuricosuria. Detection of urine oxalate and citrate was not conducted in 9 cases of oxluria due to the equipment condition. Hyperoxaluria and hypocitraturia were found in 36 cases （33.6%） and 82 cases （76.6%） respectively. Among the 107 cases with calculi, there werehad single metabolic disturbance, 2 type of metabolic disturbance, 3 types of metabolic disturbance and 4 types of metabolic disturbance were 11（10.2%）cases ,35（32.7%）cases, 44（43.1%）cases and 14（13.1%）cases respectively. ConclusionMetabolic disturbance exists in most of the residents with complex renal calculi in each community of Guangzhou City. For the the residents with complex renal calculi or the risk factors for recurrence of calculi, 24-hour urine component analysis and comprehensive metabolic assessment should be performed to prevent and treat stones effectively.