感染性肾结石患者尿代谢及细菌培养结果分析

Analysis on the results of urine metabolism and bacterial culture in patients with infectious kidney stones

目的分析感染性肾结石患者的尿代谢及细菌培养结果。方法选择2015年1月至2018年1月天津中医药大学第一附属医院收治的感染性肾结石患者87例,根据结石成分将其分为单纯感染性肾结石组[磷酸铵镁和(或)碳酸磷灰石,32例]和混合感染性肾结石组[磷酸铵镁和(或)碳酸磷灰石+草酸钙,55例]。比较两组一般临床资料、尿代谢检测结果、尿细菌培养结果及复发情况。结果两组性别、年龄、合并糖尿病、尿石症家族史情况比较差异无统计学意义(P>0.05)。单纯感染性肾结石组有尿路感染病史及慢性尿路感染因素的人数比例大于混合感染性肾结石组,差异有统计学意义(P<0.05)。混合感染性肾结石组大肠杆菌阳性比例高于单纯感染性肾结石组,变形杆菌阳性比例低于单纯感染性肾结石组,差异有统计学意义(P<0.05)。混合感染性肾结石组高钙尿症、高草酸尿症、高尿酸尿症发生率均高于单纯感染性肾结石组,差异有统计学意义(P<0.05)。术后复查,单纯感染性肾结石组复发感染和新发结石的人数比例均高于混合感染性肾结石组,差异有统计学意义(71.88%vs 32.73%,50.00%vs 20.00%;P<0.05)。结论与单纯感染性肾结石患者比较,混合感染性肾结石患者尿代谢异常的发生率更高,这可能与其结石成因有关,故对此类患者除了控制感染外,还应针对尿代谢异常情况进行治疗。

Objective To analyze the results of urine metabolism and bacterial culture in patients with infectious kidney stones.Methods Eighty-seven patients with infectious kidney stones who were admitted to First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 2015 to January 2018 were selected.According to different stone compositions,the patients were divided into the simple infectious kidney stone group(magnesium ammonium phosphate and/or carbonated apatite,n=32)and the mixed infectious kidney stone group(magnesium ammonium phosphate and/or carbonated apatite+calcium oxalate,n=55).The general clinical data,urine metabolism test results,urine bacterial culture results and recurrence were compared between the two groups.Results There were no significant differences in gender,age,complicated diabetes mellitus and family history of urolithiasis between the two groups(P>0.05).The proportion of the patients with a history of urinary tract infection and chronic urinary tract infection factors in the simple infectious kidney stone group was greater than that in the mixed infectious kidney stone group,and the difference was statistically significant(P<0.05).The positive rate of Escherichia coli in the mixed infectious kidney stone group was higher than that in the simple infectious kidney stone group,and the positive rate of Proteus species in the mixed infectious kidney stone group was lower than that in the simple infectious kidney stone group,and the differences were statistically significant(P<0.05).The incidence rates of hypercalciuria,hyperoxaluria and hyperuricuria in the mixed infectious kidney stone group were higher than those in the simple infectious kidney stone group,and the differences were statistically significant(P<0.05).The results of reexamination after operation showed that the proportion of patients with recurrent infection and new stones in the simple infectious kidney stone group was higher than that in the mixed infectious kidney stone group,and the differences were statistically significant(71.88%vs 32.73%,50.00%vs 20.00%;P<0.05).Conclusion Compared with the patients with simple infectious kidney stones,the patients with mixed infectious kidney stones have a higher incidence of abnormal urine metabolism,which may be related to the cause of the stones.Therefore,in addition to controlling infection,these patients should also be treated for their abnormal urine metabolism.