尿生化指标对妊娠合并尿路结石的诊断价值研究

Urine biochemical indicators in diagnosis of urolithiasis during pregnancy

目的研究尿生化指标检测对妊娠合并尿路结石的诊断价值。方法回顾分析2010年1月至2020年10月在扬州大学医学院附属苏北人民医院建卡并确诊为尿路结石的60例孕妇的临床资料,包括年龄、孕周、孕产次、临床表现、尿生化指标,并选取同期无结石孕妇60例及正常育龄期女性60例作为对照(分别为对照组A与对照组B)。通过统计尿液生化指标,对其进行统计学分析,比较尿液生化指标对妊娠合并尿路结石的诊断价值。结果病例组共60例,年龄(29.4±3.7)岁,发病孕周(31.8±6.8)周,怀孕次数1(0,1)次,生产次数0(0,1)次;对照组A共60例,年龄(28.7±2.5)岁,孕周(34.5±4.5)周,怀孕次数1(0,1)次,生产次数0(0,1)次;对照组B共60例,年龄(29.2±2.1)岁,怀孕次数0(0,1)次,生产次数0(0,1)次。病例组、对照组A及对照组B的pH值分别为(6.92±0.62)、(6.67±0.61)、(6.64±0.70),白细胞分别为(71.06±25.87)个/高倍镜、(27.17±10.42)个/高倍镜、(12.48±5.74)个/高倍镜,尿红细胞分别为(197.11±50.40)个/高倍镜、(188.53±57.40)个/高倍镜、(184.32±53.04)个/高倍镜,尿隐血分别为2(0,3)、0(0,0)、0(0,0)/μl,尿酮体水平分别为1(0,2)、0(0,1)、0(0,1)mmol/L,病例组与对照组A、B差异均有统计学意义(均P<0.05)。进一步进行回归分析发现在尿液生化指标中pH值、尿隐血、尿酮体、白细胞是妊娠合并尿路结石发生的独立危险因素。受试者工作特征曲线下尿白细胞联合尿隐血曲线下面积最大。结论尿液生化指标可以有效诊断妊娠合并尿路结石,在妊娠合并尿路结石疾病诊断中应常规使用。

Objective To study the value of urine biochemical indicators in the diagnosis of urolithiasis during pregnancy.Methods The clinical data of 60 pregnant women who had been diagnosed with urolithiasis at Subei Hospital from January 2010 to October 2020 were retrospectively analyzed,including age,gestational weeks,pregnant times,clinical signs,and urine biochemical indicators.Sixty pregnant women without urolithiasis and 60 normal women of childbearing age in the same period were selected as controls,including a control group A and a control group B.The urine biochemical indicators were statistically analyzed.The diagnostic values of urine biochemical indicators in the diagnosis of urolithiasis during pregnancy were compared.Results There were 60 cases in the case group;they were(29.4±3.7)years old,were(31.8±6.8)weeks pregrant,had been pregnant 1(0,1)times,and had delivered 0(0,1)times.There were 60 cases in the control group A;they were(28.7±2.5)years old,were(34.5±4.5)weeks pregrant,had been pregnant 1(0,1)times,and had delivered 0(0,1)time.There were 60 cases in the control group B;they were(29.2±2.1)years old,had been pregnant 0(0,1)times,and had delivered 0(0,1)time.The levels of pH,urinary leukocytes,urinary red blood cells,urinary occult blood,and urinary ketone were(6.92±0.62),(71.06±25.87),(197.11±50.40),2(0,3),and 1(0,2)in the case group,were(6.67±0.61),(27.17±10.42),(188.53±57.40),0(0,0),and 0(0,1)in the control group A,and were(6.64±0.70),(12.48±5.74),(184.32±53.04),0(0,0),and 0(0,1)in the control group B,with statistical differences between the case group on one hand and the control group A and the control group B on the other hand(all P<0.05).The regression analysis revealed that pH,urinary occult blood,urinary ketone,and leukocytes were independent risk factors for the development of urinary stones in pregnancy.The area under the receive operating characteristic curve of the combination of urinary leukocytes and occult blood was the biggest.Conclusion Urine biochemical indicators can effectively diagnose urolithiasis during pregnancy,and should be promoted in clinic.