尿结石成分分析和双能量CT在尿酸结石中的应用研究

Study on the application of urinary calculus component analysis and dual-energy CT in uric acid calculus

目的:应用尿结石成分分析和双能量CT检查出的尿酸结石,探讨尿酸结石在南通地区的发病特点和诊治措施,为临床尿酸结石的防治提供指导。方法:回顾性分析南通大学第二附属医院2017年2月—2020年6月诊治的944例尿结石患者,应用泌尿系结石红外光谱自动分析仪(LⅡR-20型)确诊为尿酸结石患者196例(20.8%),其中69例于治疗前应用双能量CT检查诊断为尿酸结石,结合临床资料分析相关因素。结果:尿酸结石196例,年龄24~88岁,平均(59.4±12.2)岁,男170例,女26例;肾脏结石99例(50.5%),输尿管结石54例(27.6%),膀胱结石40例(20.4%),尿道结石3例(1.5%)。单一成分无水尿酸99例(50.5%),二水尿酸53例(27.1%);无水尿酸为主的混合性结石44例(22.4%),各年龄组中尿酸类结石在中老年组(51~70岁)比例高。其中治疗前用双能量CT检查出的尿酸结石(69例)与红外光谱自动分析仪分析的尿结石成分结果一致。结论:南通地区尿酸结石的发病率偏高,以无水尿酸为主,存在年龄、性别、发病部位的差异,双能量CT与尿结石成分分析对尿酸结石的诊断结果一致,对尿酸结石诊治和预防具有指导作用。

Objective:To explore the application of urinary stone component analysis and dual-energy CT for analyzing the uric acid stones,to explore the characteristics and diagnosis and treatment of uric acid stones in this area,and to provide guidance for the clinical prevention and treatment of uric acid stones.Methods:A retrospective analysis of 944 patients with urinary calculi diagnosed and treated in the Second Affiliated Hospital of Nantong University from February 2017 to June 2020,196 patients with uric acid calculi were diagnosed with urinary calculi infrared spectrum automatic analyzer(LⅡR-20 type),69 of them before treatment,dual-energy CT were also diagnosed as uric acid stones,and related factors were analyzed based on clinical data.Results:Among the 944 patients with urinary stones,196 cases(20.8%)were uric acid stones,aged 24 to 88 years old,with an average age of(59.4±12.2)years,of which 170 were males and 26 were females;99 cases(50.5%)were kidney stones at the site of disease.54 cases(27.6%)of ureteral stones,40 cases(20.4%)of bladder stones,3 cases(1.5%)of urethral stones.99 cases(50.5%)of single component anhydrous uric acid;53 cases(27.1%)of dihydrate uric acid;44 cases(22.4%)of mixed stones dominated by anhydrous uric acid.Among all age groups,uric acid stones were in the middle-aged and elderly group(51-70 years old)has a high proportion.Among them,the uric acid stones(69 cases)detected by dual-energy CT before treatment were consistent with the results of urinary stones analyzed by infrared spectroscopy automatic analyzer.Conclusion:The incidence of uric acid stones in Nantong area is relatively high.Anhydrous uric acid is the main cause.There are differences in age,sex,and location of the disease.Dual-energy CT and urinary stone component analysis are consistent in the diagnosis of uric acid stones,which has a guiding role in its diagnosis,treatment and prevention.