66例新疆维吾尔族儿童泌尿系结石成分分析

Analysis of urinary stone compositions for 66 Uyghur children in Xinjiang

目的探讨新疆维吾尔族小儿泌尿系结石病的临床特点,分析各结石成分与患者性别、年龄和结石发生部位的关系。方法收集2017年2月至2019年4月在新疆维吾尔自治区人民医院接受治疗的66例小儿泌尿系结石标本,采用红外光谱分析法进行结石成分分析,结合临床资料进行统计分析。所有患者按照结石类型分为单纯型结石(n=44)和混合型结石(n=22),按照结石成分分为尿酸氢铵(n=22)、草酸钙(n=19)、草酸钙+碳酸磷灰石(n=15)和其他结石(n=10)。结果66例平均年龄为(4.52±3.41)岁(3个月至12岁),男童53例(80.30%),女童13例(19.70%),男女性别比例为4.08∶1;66例结石患者中幼儿组患者数量多于其他年龄段;结石标本成分以单纯型结石为主,占66.67%(44/66),主要为尿酸氢铵和草酸钙,分别占单纯型结石的50.00%(22/44)和43.18%(19/44);尿酸氢铵结石患者多发生在幼儿组,共12例(54.55%);碳酸钙结石患者多发生在学龄组(6岁<年龄≤12岁),共8例(42.11%);混合型结石成分以草酸钙+碳酸磷灰石为主,共15例,占混合型结石的68.18%,多发生在学龄前组,共7例(46.67%);上尿路结石多于下尿路结石(74.24%vs.25.76%),但不同结石成分在结石发生部位分布上无统计学差异(P>0.05)。结论新疆地区维吾尔族小儿泌尿系统结石以单纯型结石为主,发病年龄早,且主要发生在上尿路,不同结石成分患者性别和年龄分布存在差异。

Objective To explore the clinical characteristics of pediatric urinary calculus in Xinjiang Uyghur children and analyze the relationship between stone composition with gender,age and location of stone and ultimately to provide clinical rationales for managing urinary stone.Methods A total of 66 urinary stone samples were collected from children from February 2017 to April 2019.All samples were analyzed by infrared spectroscopy.Their clinical data were also explored.The categories were simple(n=44)and mixed(n=22).Based upon compositions,the types were ammonium hydrogen urate(n=22),calcium oxalate(n=19),calcium oxalate plus carbonate apatite(n=15)and miscellaneous(n=10).Results The average age was(4.52±3.41)(0.25-12)years.There were 53 boys(80.30%)and 13 girls(19.70%)with a gender ratio of 4.08:1.The number of children in 1<age≤3 group was more than that in other age groups.Ammonium hydrogen urate was more common in 1<age≤3 group while calcium oxalate predominated in school age group(6<age≤12).The remaining stone samples were mixed stones composed mostly of calcium oxalate and carbonate apatite(68.18%)and predominated during preschool age(3<age≤6).The proportion of upper urinary stones was much higher than of lower urinary stones(74.24%vs.25.76%).However,no significant difference existed in the distribution of stone location among different stone compositions.Conclusion Uyghur children with urolithiasis are young and simple stones predominate.With an early onset,urinary stones have diverse compositions for different ages and genders.Etiological explorations are essential for managing pediatric urolithiasis locally.