泌尿系结石患者结石及尿液成分与结石复发相关性分析

Correlation Analysis of Stone and Urine Composition and Stone Recurrence in Patients with Urinary Calculi

目的:探讨泌尿系结石患者结石成分及尿液成分与结石复发之间的相关性。方法:选取2019年3月至2021年5月在我院进行治疗的120例泌尿系结石患者为研究对象,均随访一年,记录术后结石复发率,根据结石是否复发将其分组,分析患者一般临床资料,探讨影响结石复发的危险因素,并进一步分析结石成分及尿液成分与结石复发相关性。结果:120例患者中有27例患者结石复发,1年复发率为22.50%;复发组≥70岁占比62.96%高于未复发组40.86%,复发组手术清石率≥80%占比率66.67%低于未复发组90.32%,复发组内分泌疾病史占比率55.56%高于未复发组21.50%(P<0.05);复发组尿液成分中pH值(5.36±0.58)低于未复发组(6.89±0.71),尿酸、草酸、磷分别为(2.67±0.26)mmoL/L、(0.52±0.05)mmoL/L、(15.49±2.47)mmoL/L,均高于未复发组(2.15±0.28)mmoL/L、(0.41±0.06)mmoL/L、(12.36±2.38)mmoL/L(P<0.05);复发组磷酸镁铵类成分占比66.67%高于未复发组23.66%(P<0.05);Logistic回归分析发现,年龄≥70岁、内分泌疾病史、磷酸镁铵类结石成分、手术清石率<80%及尿液成分pH值、尿酸、草酸、磷均是影响泌尿系结石患者结石复发的危险因素;相关性分析发现,结石成分中磷酸镁铵类与结石复发呈正相关(r=0.536,P<0.05),尿液成分中pH值与结石复发呈负相关(r=-0.417,P<0.05),尿酸、草酸、磷与结石复发呈正相关(r分别为0.387、0.425、0.439,P<0.05)。结论:泌尿系结石患者术后结石复发率较高,尤其是年龄≥70岁、内分泌疾病史、磷酸镁铵类结石成分、手术清石率<80%及尿液成分pH值、尿酸、草酸、磷较低者,临床需针对以上患者加强相关治疗,降低结石复发风险。

Objective:To investigate the correlation between stone and urine composition and stone recurrence in patients with urinary calculi.Methods:A total of 120 patients with urinary calculi were treated in the hospital from March 2019 to May 2021.They were selected as the research subjects,and followed up for 1 year.The postoperative stone recurrence rate was recorded.The patients were grouped according to the presence or absence of stone recurrence.General clinical data of the patients were analyzed to screen the risk factors for stone recurrence.The correlation between stone and urine composition and stone recurrence was analyzed.Results:Among the 120 patients,27 patients had stone recurrence,and the 1-year recurrence rate was 22.50%.The proportion of patients aged 70 or older in the recurrence group(62.96%)was higher than that in the non-recurrence group(40.86%).The proportion of surgical stone removal rate≥80%in the recurrence group(66.67%)was lower than that in the non-recurrence group(90.32%).The proportion of patients with history of endocrine diseases in the recurrence group(55.56%)was higher than that in the non-recurrence group(21.50%)(P<0.05).The pH value of urine components in the recurrence group(5.36±0.58)was lower than that in the non-recurrence group(6.89±0.71).The levels of uric acid,oxalic acid and phosphorus[(2.67±0.26)mmoL/L,(0.52±0.05)mmoL/L and(15.49±2.47)mmoL/L]were higher than those in the non-recurrence group[(2.15±0.28)mmoL/L,(0.41±0.06)mmoL/L and(12.36±2.38)mmoL/L](P<0.05).The proportion of magnesium ammonium phosphate in the recurrence group(66.67%)was higher than that in the non-recurrence group(23.66%)(P<0.05).Logistic regression analysis showed that age≥70,history of endocrine disease,magnesium ammonium phosphate in stone composition,surgical stone clearance rate<80%,urine pH value,uric acid,oxalic acid,and phosphorus were risk factors for stone recurrence in patients with urinary calculi.Correlation analysis showed that magnesium ammonium phosphate in the stone components was positively correlated with the recurrence of stones(r=0.536,P<0.05),pH in urine components was negatively correlated with the recurrence of stones(r=-0.417,P<0.05),and uric acid,oxalic acid and phosphorus were positively correlated with the recurrence of stones(r=0.387,0.425,0.439,P<0.05).Conclusion:Patients with urinary calculi have a relatively high rate of postoperative stone recurrence,especially those aged≥70,with history of endocrine disease,with magnesium ammonium phosphate in stone composition,with surgical stone clearance rate<80%,lower urine pH,lower urine uric acid,oxalic acid and phosphorus.Clinically,treatment for the above patients should be strengthened to reduce the risk of stone recurrence.