闽南地区2983例泌尿系结石患者的结石成分和临床特点分析

Stone Composition Analysis and Clinical Characteristics of 2983 Patients with Urinary Calculi in Southern Fujian

目的 分析闽南地区泌尿系结石(结石)患者的结石成分和不同性别结石患者的临床特点。方法 回顾性分析2 983例结石患者的结石标本,应用结石红外光谱自动分析仪确定结石成分,结合临床资料分析不同性别及不同年龄患者的结石分布特点。结果 2 983例结石患者中,男女比例为2.15∶1,其中混合型结石2 238例,以一水草酸钙+二水草酸钙+碳酸磷灰石多见(40.0%),一水草酸钙+二水草酸钙(21.4%)次之;单纯型结石745例,以一水草酸钙为主(71.3%),尿酸结石(16.6%)次之。混合型结石中,男、女性患者结石成分前三位均为一水草酸钙+二水草酸钙+碳酸磷灰石、一水草酸钙+二水草酸钙和一水草酸钙+碳酸磷灰石。女性患者一水草酸钙+二水草酸钙结石和感染性结石多于男性患者(P<0.05)。单纯型结石中,男性患者以草酸钙(70.6%)、尿酸结石(19.2%)和感染性结石(3.2%)为主,女性患者主要为草酸钙(72.9%)、尿酸结石(无水尿酸和尿酸铵,12.5%)和感染性结石(碳酸磷灰石和六水磷酸镁铵,8.6%),男性患者的尿酸类结石占比高于女性患者,女性患者的感染性结石占比高于男性患者,差别均有统计学意义(P<0.05)。31~45岁男性结石患者占比多于女性患者(P<0.001),46~60岁男性结石患者占比少于女性患者(P<0.001)。男、女性结石患者45岁之后的占比均大于45岁之前(P<0.001)。结论 闽南地区结石患者以混合型结石为主,结石主要的成分为一水草酸钙,单纯型结石中尿酸结石的比例较高,不同性别患者的结石成分存在差别。根据结石成分的特点可采取针对性的防治措施。

Objective To analyze the composition of urinary stones and the clinical characteristics of patients with urinary stones of different genders in Southern Fujian.Methods The calculi specimens of 2983 patients with urolithiasis were retrospectively analyzed.The stone composition was determined by automatic infrared spectrum analyzer,and the stone distribution characteristics of different genders and different ages were analyzed in combination with clinical data.Results In 2983 patients with calculi,the ratio of male to female was 2.15∶1.In 2238 patients with mixed calculi,calcium oxalate monohydrate+calcium oxalate dihydrate+carbonate apatite was the most common(40.0%),followed by calcium oxalate monohydrate+calcium oxalate dihydrate(21.4%).In 745 patients with simple calculi,calcium oxalate monohydrate was the most common(71.3%),followed by uric acid calculi(16.6%).In mixed calculus,the top three stone components of male and female were calcium oxalate monohydrate+calcium oxalate dihydrate+carbonate apatite,calcium oxalate monohydrate+calcium oxalate dihydrate,calcium oxalate monohydrate+carbonate apatite.The calcium oxalate monohydrate+calcium oxalate dihydrate calculi and infectious calculi were more common in females than in males(P<0.05).In simple type calculi,calcium oxalate(70.6%),uric acid calculi(19.2%)and infectious calculi(3.2%)were predominant in male calculi,while calcium oxalate(72.9%),uric acid calculi(anhydrous uric acid and ammonium urate,12.5%)and infectious calculi(carbonate apatite and ammonium magnesium phosphate hexahydrate,8.6%)were the most common in females.The proportion of uric acid stones in males was higher than that in females,and the proportion of infectious stones in females was higher than that in males,The differences were statistically significant(P<0.05).The proportion of male patients between 31 and 45 years old was higher than that of female patients(P<0.001),and the proportion of male patients between 46 and 60 years old was lower than that of female patients(P<0.001).The proportion of male and female stone patients after 45 years old are both greater than that before 45 years old(P<0.001).Conclusion The urinary calculi in Southern Fujian are mainly mixed calculi,which the main component is calcium oxalate monohydrate.Besides,the proportion of uric acid calculi is also high in in simple stones,and the main stone composition varies in different genders.Targeted prevention and treatment measures can be taken according to the characteristics of urinary calculi.