上尿路结石成分与循环维生素水平的相关性研究

The correlation between components of upper urinary tract stones and circulating vitamin levels

目的探讨上尿路结石患者的血浆维生素水平与结石成分的关系。方法选取2020年1月至2021年8月在本院收治的上尿路结石患者(结石组,320例)和同期非尿路结石患者(对照组,90例)的临床资料,再将结石组分为感染性结石组(80例)和非感染性结石组(240例),并将结石组患者按结石成分分为磷酸盐结石组(162例)、草酸盐结石组(106例)、尿酸盐结石(29例)和碳酸钙结石组(20例)、磷酸镁铵(2例)和胱氨酸结石(1例)。记录所有患者的血浆维生素水平,同时收集并分析患者术后的结石成分,分析两组的维生素水平差异和引起上尿路结石的相关影响因素。结果结石组中占比最大的是磷酸钙结石,其次是草酸钙结石,占比最小的是胱氨酸结石。结石组和对照组患者的血浆维生素A、维生素B1(2、6、9、12)、维生素C、维生素D及维生素E水平比较,差异均无统计学意义(均P>0.05)。感染性结石组和非感染性结石组的上述血浆维生素水平比较,差异均无统计学意义(均P>0.05)。与对照组相比,磷酸盐、草酸盐、尿酸盐和碳酸钙结石组患者中的血浆维生素B2(6、12)、维生素C、维生素D及维生素E比较,差异均无统计学意义(均P>0.05),但维生素B1、维生素B9、维生素A比较,差异均有统计学意义(均P<0.05)。碳酸钙结石组患者的血浆维生素A较其他组升高,差异均有统计学意义(均P<0.05)。尿酸结石组中的维生素B1、维生素B9水平低于草酸钙结石组、磷酸钙结石组,差异均有统计学意义(均P<0.05)。结石组的血尿酸水平高于对照组(P<0.05),尿酸结石组的血尿酸升高最明显。维生素B1与血尿酸水平存在相关性(r=-0.878,P<0.05)。结论碳酸钙结石患者的血浆维生素A升高,尿酸结石患者的血浆维生素B1、维生素B9降低,调整患者维生素水平可能有助于降低特定结石的形成风险。

Objective To investigate the relationship between the plasma vitamin level and the calculi composition of the patients with upper urinary calculi.Methods The clinical data of patients with upper urinary tract calculi admitted to our hospital from January 2020 to August 2021(calculus group,320 cases)and non-urinary tract calculi patients(control group,90 cases)during the same period were selected,and the calculi group was divided into infectious calculi group(80 cases)and non-infectious calculi group(240 cases).The calculi group was divided into phosphate calculi group(162 cases),oxalate calculi group(106 cases),urate calculi group(29 cases),calcium carbonate calculi group(20 cases),ammonium magnesium phosphate(2 cases)and cystine calculi group(1 case).The plasma vitamin levels of all patients were recorded,and the postoperative stone components were collected and analyzed.The difference of vitamin levels between the two groups and the related factors causing upper urinary tract stones were analyzed.Results The proportion of calcium phosphate stones is the largest,followed by calcium oxalate stones,the proportion of cystine stones is the least.There were no significant differences in plasma levels of vitamin A,vitamin B1(2,6,9,12),vitamin C,vitamin D and vitamin E between calculus group and control group(all P>0.05).There was no significant difference in the above plasma vitamin levels between the infective calculus group and the non-infective calculus group(all P>0.05).Compared with the control group,there were no statistically significant differences in plasma vitamin B2(6,12),vitamin C,vitamin D and vitamin E in phosphate,oxalate,urate and calcium carbonate stone groups(all P>0.05),but there were statistically significant differences in plasma vitamin Bl,vitamin B9 and vitamin A(all P<0.05).Plasma vitamin A in calcium carbonate stone group was higher than that in other groups,and the differences were statistically significant(all P<0.05).The levels of vitamin B1 and vitamin B9 in uric acid calculus group were lower than those in calcium oxalate calculus group and calcium phosphate calculus group,and the differences were statistically significant(all P<0.05).The blood uric acid level in the calculus group was higher than that in the control group(P<0.05),and the increase of blood uric acid in the calculus group was the most obvious.There was a correlation between vitamin Bl and blood uric acid level(r=-0.878,P<0.05).Conclusions Plasma vitamin A is increased in patients with calcium carbonate stones,and plasma vitamin Bl and vitamin B9 are decreased in patients with uric acid stones.Adjusting the levels of this vitamin may help reduce the risk of formation of specific stones.