1849例泌尿系结石种类及其与患者临床特征的关系

Types for 1 849 patients with urinary calculi and patients' clinical characteristics

目的:分析湖南省泌尿系结石种类与患者临床特征的关系,探讨泌尿系结石防治策略。方法:收集中南大学湘雅三医院泌尿外科收治的1 849例来自湖南省14个州市的泌尿系结石患者的结石,使用红外光谱分析技术分析结石成分。根据患者的临床特征分析结石种类与临床参数的关系。结果:所有结石分为6类,男性中草酸钙结石和尿酸结石分别占84.1%和7.7%;女性中草酸钙结石和尿酸结石分别占78.4%和4.2%,男性草酸钙结石、尿酸结石所占比例高于女性(P<0.05)。年龄越大尿酸结石所占比例越高(<18岁为0.0%;18~<41岁为1.6%;41~<66岁为6.6%;≥66岁为12.4%)。不同BMI结石种类构成比差异无统计学意义(P>0.05)。是否合并有尿路感染、高血压、糖尿病对结石种类构成无明显影响(P>0.05)。尿液p H值呈正常、酸性、碱性的患者尿酸结石比例分别为0.3%,13.8%和10.3%,尿液呈酸性患者中尿酸结石比例较高。肌酐升高患者中含尿酸结石的比例高于肌酐正常患者(12.1%vs 4.5%,P<0.05)。结论:老年患者、尿液呈酸性和肾功能不全患者较易发生尿酸结石,而改变尿液p H可能是防治湖南省泌尿系结石的重要策略。

Objective＂ To analyze types of urinary calculi and patients＇ clinical characteristics, and to explore the strategies for prevention and treatment of urinary calculi. Methods： A total of 1 849 patients with urinary calculi were treated in the Department of Urology, the Third Xiangya Hospital of Central South University. The components were analyzed by infrared spectroscopy. The relationship between stone composition and clinical parameters was analyzed according to the clinical characteristics of the patients.Results： The proportion of calcium oxalate stone or uric acid stone in male （84.1% or 7.7%） was higher than that in female （78.4% or 4.2%）. The older patients were more likely to be diagnosed as uric acid stone. The proportions of uric acid stone in patients 〈 18 years old, 18-〈41 years old, 41-〈66 years old, and ≥66 years old were 0.0%, 1.6%, 6.6%, and 12.4%, respectively. There was no significant difference in the proportion of stones in patients with different BMI. There were no significant difference in the stone composition between the patients with or without urinary tract infection, hypertension or diabetes. ＂[he proportion of uric acid stones in patients with acidic urine was higher than the other types. The proportion of uric acid stones in patients with elevated creatinine （12.1%） was higher than that in the patients with normal creatinine （4.5%）. Conclusion： Elderly patients, or patients with high uric acid and renal insufficiency are more prone to uric acid stones. Regulation of urinary pH may be an important strategy for preventing and treating urinary calculi in Hunan Province.