甘肃陇南地区泌尿系结石成分分析

Analysis of urinary calculi composition in Longnan,Gansu province

目的分析甘肃陇南市泌尿系结石患者的结石成分构成及其与患者临床特征的关系,以期为该地区泌尿系结石的临床防治提供参考。方法应用红外光谱结石成分分析仪对2021年4月—2023年2月于陇南市第一人民医院诊治的500例泌尿系结石患者进行结石成分分析,评估分析患者群体的临床特征。结果500例泌尿系结石患者中男女比例为2.70∶1,以21~60岁年龄段人群多见,共437例(87.4%),其中输尿管结石多发(72.8%)、肾结石次之(22.2%)、膀胱结石最少(5.0%)。草酸钙成分166例、草酸钙+碳酸磷灰石混合成分293例、草酸钙+碳酸磷灰石+羟基磷灰石混合结石患者24例、草酸钙+磷酸氢钙结石患者4例、尿酸盐结石患者7例、碳酸磷灰石+磷酸铵镁患者6例。草酸钙结石在各个年龄阶段均占比较高,尿酸盐结石在21~40岁人群多发。草酸钙结石在输尿管内发生最多127例(76.5%)较其他部位差异有统计学意义(χ^(2)=3.222,P=0.020)。草酸钙和磷酸氢钙混合结石膀胱内最少,较其他部位差异有统计学意义(χ^(2)=2.092,P=0.037)。六水磷酸镁铵和(或)碳酸磷灰石或草酸钙肾脏内最多(50.0%),较其他部位的结石构成差异有统计学意义(χ^(2)=9.448,P=0.007)。结论甘肃陇南地区泌尿系结石患者男性多于女性,以输尿管结石多发,成分以草酸钙+碳酸磷灰石及草酸钙结石为主。根据不同的危险因素,应制定个体化预防方案。

Objective To analyze the composition of urinary calculi in Longnan,Gansu province,and the relationship between the composition and clinical characteristics of patients,so as to provide reference for the prevention and treatment of this disease.Methods The composition of 500 cases of urinary calculi hospitalized in our department during Apr.2021 and Feb.2023 were analyzed using the infrared spectrum stone composition analyzer.The clinical characteristics of the patients were evaluated and analyzed.Results The male-to-female ration of patients was 2.70∶1.Most patients aged 21 to 60 years(437,87.4%).Most cases were ureteral calculi(72.8%),followed by renal calculi(22.2%),and bladder calculi(5.0%).There were 166 cases of calcium oxalate calculi,293 cases of calcium oxalate+carbonated apatite calculi,24 cases of calcium oxalate+carbonated apatite+hydroxyl apatite calculi,4 cases of calcium oxalate+calcium bicarbonate calculi,7 cases of urate calculi,6 cases of carbonated apatite+struvite calculi.Oxalate calculi were the most common in all age groups,and urate calculi were the most common in the 21 to 40 age group.Calcium oxalate calculi were most common in the ureter(127,76.5%),significantly higher than in other sites(χ^(2)=3.222,P=0.020).Calcium oxalate+calcium hydrogen phosphate calculi was the least common in the bladder,significantly different from the other parts(χ^(2)=2.092,P=0.037).Magnesium ammonium phosphate hexahydrate and/or calcium carbonate or calcium oxalate calculi were the most common in the kidney(50.0%),significantly different from the other parts(χ^(2)=9.448,P=0.007).Conclusion In Longnan area,the incidence of urinary calculi is significantly higher in male than in female.Ureteral calculi are mainly composed of calcium oxalate+carbonated apatite and calcium oxalate.According to different risk factors,individual prevention programs should be developed.