武汉市及周边地区3735例泌尿系结石患者的结石成分分析

Composition analysis of 3735 cases of urinarycalculi in wuhan and its surrounding areas

目的分析武汉市及周边地区3735例泌尿系结石患者的结石成分,为泌尿系结石的临床防治提供帮助。方法回顾性分析武汉大学人民医院2016年8月至2018年12月收治的3735例泌尿系结石患者的临床资料,以红外光谱法分析泌尿系结石的化学成分,并以患者性别、年龄、结石部位等为分组依据,分析各组泌尿系结石的化学成分特征。结果51〜60岁组泌尿系结石发病率达高峰,其次为41〜50岁组;男性与女性泌尿系结石患者的比率为1.9:1;单一结石成分有1422例(38.07%)、两种结石成分1656例(44.34%)、三种结石成分633例(16.95%)、四种结石成分24例(0.64%);结石成分检出率最高的为一水草酸钙(80.16%)、其后依次是碳酸磷灰石(55.58%)、二水草酸钙(28.59%)、无水尿酸(8.76%)、六水磷酸铵镁(4.02%),二水磷酸氢钙(0.72%)、羟基磷灰石(0.48%)、胱氨酸(0.16%)。结论武汉市及周边地区大部分为2~4种结石成分的混合性结石,其中以含一水草酸钙和碳酸磷灰石2种成分结石最为多见。掌握泌尿系结石的成分对于了解结石的成因,指导治疗及预防复发有重要的临床意义。

Objective To analyze stone composition in 3735 patients with urinary calculi for clinical prevention and treatment.Methods A total of 3735 cases of urinary calculi in our hospital from August 2016 to December 2018 were retrospectively analyzed.The chemical constituents of urinary caIculi were analyzed by infrared spectroscopy.The chemical constituents of urinary calculi in each group were analyzed on the basis of sex,age and location of calculi.Results The incidence of urinary calculi reached the peak in 51-60 years old group,followed by 41-50 years old group,the ratio of male to female patients was 1.9:1,and there were 1422 cases(38.07%)with single component calculus,1656 cases(44.34%)with 2 kinds of component calculus,633 cases(16.95%)with 3 kinds of com-ponent calculus and 24 cases(0.64%)with 4 kinds of component calculus.The highest detection rate of calculi was calcium oxalate monohydrate(80.16%).The second was apatite carbonate(55.58%),calcium oxalate dihydrate(28.59%),anhydrous uric acid(8.76%),magnesium ammonium phosphate hexahydrate(4.02%),calcium hydrogen phosphate dihydrate(0.72%),hydroxyapatite(0.48%)and cystine(0.16%).Conclusions Most of the stones in Wuhan city surounding areas are mixed stones with 2 to 4 kinds of stones,of which calcium oxalate monohydrate and apatite carbonate are the most common.Mastering the composition of urinary calculi is of great clinical significance for understanding the causes of calculi,guiding treatment and preventing recurrence.