红外光谱分析对泌尿系结石成分分析及预防指导的应用意义

Significance of Infrared Spectroscopy Analysis Applied for Urinary Calculi Components Analysis and Prevention Guidance

目的评价红外光谱自动分析系统在泌尿系结石成分分析中的应用,并通过结石成分分析探讨相关结石预防措施的临床应用价值。方法回顾性分析本中心自2014年6月1日至2015年4月1日通过内镜手术收集到122例尿路结石患者信息。以红外光谱自动分析法对收集的结石标本行化学成分分析,研究不同结石成分与性别、结石发生部位之间的关系。并查阅和复习相关文献,探讨结石成分分析对相关结石预防指导在实际临床应用中的价值与意义。结果 122例泌尿系结石中,含一水草酸钙者最多(90.4%),其次是碳酸磷灰石(47.6%)和二水草酸钙(32.3%),无水尿酸(9.8%)与六水磷酸铵镁(4.1%)等其他成分均少见。单一种成分结石42例,混合成分结石共80例(二种成分结石38例,三种成分结石31例,四种成分结石6例);单一成分结石最常见为一水草酸钙(77.8%);最常见混合结石成分为一水草酸钙+碳酸磷灰石(75%)。通过检验,肾结石与输尿管结石中,不同成分结石的分布数据并无统计学差异(P>0.05),而上尿路结石与下尿路结石的结石成分分布数据存在统计学差异(P<0.05)。此外,不同性别的结石成分构成比存在统计学差异(P<0.05)。结论红外光谱自动分析可快速、简便、准确地分析尿路结石成分。根据尿路结石成分对患者进行相关结石的预防指导,可有效降低尿路结石的复发率。适合于临床推广及常规使用。

Objective To evaluate the significance of the analysis of urinary calculi components analyzed by Infrared Spectroscopy（ IR） automatic analysis system,and to discuss the clinical value of prevention guidance for associated urinary calculi. Methods One hundred and twenty-two urinary calculi cases who underwent endoscopic surgery operation in our department from Jun 1st,2014 to Apr 1st,2015 were retrospectively analyzed.There were 70 male cases and 52 female cases. And the number of renal calculi,ureteral calculi,lower urinary tract（ bladder and urethra） calculi was 57 cases,59 cases and 6 cases,respectively. Through infrared spectroscopy,the chemical components of the stone specimens were automaticly analyzed. The differences between the composition of stones,gender and stones＇ position were statistically analyzed. And the value and significance of stones composition analysis were used for the prevention guidance of relevant stones in the practical clinical application. Results In 122 cases of urinary calculi,90. 4% cases contained calcium oxalate monohydrate,47. 6% cases contained carbonated apatite,and 32. 3% cases contained calcium oxalate dihydrate. Anhydrous acid（ 9. 8%） and phosphoric acid hexahydrate（ 4. 1%） are rare contents in the urinary calculi. 42 cases of urinary calculi had a single ingredient,and 80 cases of stones contained mixed ingredients（ 38 cases had two ingredients,31 cases had three ingredients,and 6 cases of four ingredients）; The most common single ingredients stones is calcium oxalate monohydrate（ 77. 8%）; the most common ingredients in mixed stones are calcium oxalate monohydrate and carbonated apatite（ 75%）. By examination,the distribution of different components of stones in kidney and ureter has no significant difference（ P 〉0. 05）,however,the components of upper urinary tract stones and lower urinary tract stones were significantly different（ P 〈0. 05）. In addition,stones composition ratio of different gender was significantly different（ P 〈0. 05）. Conclusions IR automatic analysis can analyze the composition of urinary tract stones quickly,easily and accurately. Providing prevention guidance for patients according to the results of infrared spectroscopy automatic analysis of stone components,it can reduce the recurrence rate of urinary tract stones effectively. And it is suitable for routine clinical use.