单中心483例泌尿系结石成分分析及临床意义

COMPOSITION OF URINARY CALCULI AND ITS CLINICAL SIGNIFICANCE: A SINGLE-CENTER ANALYSIS OF 483 CASES

目的分析青岛及周边地区泌尿系结石成分,探讨其临床意义。方法回顾性分析青岛大学附属医院泌尿外科诊治的483例泌尿系结石病人的临床资料,采用第二代红外线光谱结石分析仪测量结石成分。结果尿路结石在组成上分为单一成分结石和混合成分结石两类,分别占47.62%和52.38%。单一成分结石以草酸钙和无水尿酸成分为主,各占64.38%和33.48%;混合成分结石以一水草酸钙+二水草酸钙+碳酸磷灰石、无水尿酸+一水草酸钙和碳酸磷灰石+羟基磷灰石构成为主,各占65.61%、18.19%和13.83%。结石按部位分为上尿路结石和下尿路结石,各占92.96%和7.04%,上尿路结石所占比例明显高于下尿路结石,但结石部位与性别无关(P>0.05)。各年龄段结石占比以40~59、60~79岁年龄段较高,分别占45.76%和41.82%,而且随着年龄增长下尿路结石的占比增高,0~19、20~39、40~59、60~79、≥80岁年龄段的下尿路结石占比分别为0、0、1.81%、11.39%和53.85%。结论以草酸钙和无水尿酸为主要成分的尿路结石是青岛及周边沿海地区尿路结石的主要类型,其原因可能与本地区特殊的地理位置及饮食结构有关,根据结石成分指导病人调整饮食构成对防止尿路结石的发生发展具有重要的临床意义。

Objective To analyze the composition of urinary calculi in Qingdao and surrounding areas of China, and to investigate its clinical significance. Methods A retrospective analysis was performed for the clinical data of 483 patients with urinary calculi who were diagnosed and treated in Department of Urology, The Affiliated Hospital of Qingdao University, and thesecond-generation infrared spectroscopy stone analyzer was used to analyze the composition of calculi. Results Based on composition, urinary calculi were divided into single-component calculi and mixed-component calculi, accounting for 47.62% and 52.38%, respectively. Single-component calculi were mainly composed of calcium oxalate or anhydrous uric acid, accounting for 64.38% and 33.48%, respectively;mixed-component calculi were mainly composed of calcium oxalate monohydrate+calcium oxalate dihydrate+carbonate apatite, anhydrous uric acid+calcium oxalate monohydrate, or carbonate apatite+hydroxyapatite, which accounted for 65.61%,18.19%, and 13.83%, respectively. According to location, urinary calculi were divided into upper urinary tract calculi and lower urinary tract calculi, and upper urinary tract calculi had a significantly higher proportion than lower urinary tract calculi(92.96% vs 7.04%);the location of calculi was not associated with sex(P>0.05). The analysis of age groups showed that the patients aged 40-59 and 60-79 years accounted for 45.76% and 41.82%, respectively, and the proportion of lower urinary tract calculi increased with age, accounting for 0, 0,1.81%,11.39%, and 53.85%, respectively, in the age groups of 0-19, 20-39, 40-59, 60-79, and ≥80 years. Conclusion Urinary calculi with the main components of calcium oxalate and anhydrous uric acid are the main type of urinary calculi in Qingdao and surrounding coastal areas, which may be associated with the special geographical location and dietary structure of this region. Guiding patients to adjust their dietary structure based on the composition of calculi is of great clinical significance in preventing the development and progression of urinary tract stones.