血尿酸及血脂水平对于肾结石的诊断价值分析

Analysis of the Diagnostic Value of Serum Uric Acid and Lipid Levels for Kidney Stones

目的探讨血尿酸及血脂水平对于肾结石的诊断价值。方法回顾性分析聊城市中医医院2020年2月—2022年1月收治的125例肾结石患者的临床资料,全部患者均经过超声检查诊断后确诊,并将其作为结石组,分为草酸钙结石组(n=32)、尿酸结石组(n=35)、磷酸盐结石组(n=31)、膀氨酸结石组(n=27),同时选择来院进行常规体检的健康成年人100名作为对照组。对比不同组别血尿酸及血脂水平,探讨血尿酸及血脂水平对肾结石的诊断价值。结果草酸钙结石组血尿酸水平为(425.36±98.12)μmol/L,高于尿酸结石组的(345.98±8.55)μmol/L、磷酸盐结石组的(311.55±65.14)μmol/L、膀氨酸结石组的(304.36±68.21)μmol/L、对照组的(206.36±60.12)μmol/L,差异有统计学意义(P<0.05)。草酸钙结石组、尿酸结石组、磷酸盐结石组、膀氨酸结石组总胆固醇(total cholesterol,TC)水平、三酰甘油(triglycerides,TG)水平、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)高于对照组,高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)水平低于对照组;草酸钙结石组TC、LDL-C水平高于尿酸结石组、磷酸盐结石组、膀氨酸结石组,HDL-C水平低于尿酸结石组、磷酸盐结石组、膀氨酸结石组;尿酸结石组TC、TG、LDL-C水平高于磷酸盐结石组、膀氨酸结石组,HDL-C水平低于磷酸盐结石组、膀氨酸结石组,差异有统计学意义(P<0.05)。将超声诊断发现肾结石作为诊断金标准,对全部肾结石患者的血尿酸及血脂水平进行检测与分析,实施受试者工作特征(receiver operating characteristic,ROC)曲线分析可见,血尿酸、TC、TG、HDL-C、LDL-C检测肾结石结果AUC分别为0.941、0.893、0.910、0.111、0.638。结论在肾结石患者当中血生化血尿酸、血脂水平明显异常,在草酸钙结石患者血清中可表现出较高的水平,用于诊断肾结石均具有较高的应用价值。

Objective To explore the diagnostic value of serum uric acid and lipid levels for kidney stone.Methods The clinical data of 125 patients with kidney stone admitted to Traditional Chinese Medicine Hospital in Liaocheng City from February 2020 to January 2022 were retrospectively analyzed.All patients were diagnosed by ultrasonography and were classified as calculus group.Calcium oxalate stone group(n=32),uric acid stone group(n=35),phosphate stone group(n=31),synergic acid stone group(n=27),and 100 healthy adults who came to the hospital for routine physical examination were selected as the control group.To evaluate the diagnostic value of serum uric acid and lipid levels in renal stones by comparing the levels of serum uric acid and lipid in different groups.Results The serum uric acid level of calcium oxalate stone group was(425.36±98.12)μmol/L.It was higher than(345.98±8.55)μmol/L in uric acid stone group,(311.55±65.14)μmol/L in phosphate stone group,(304.36±68.21)μmol/L in synergic acid stone group and(206.36±60.12)μmol/L in control group.The difference was statistically significant(P<0.05).The levels of total cholesterol(TC),triglycerides(TG)and low density lipoprotein cholesterol(LDL-C)in calcium oxalate stone group,uric acid stone group,phosphate stone group,and synergic acid stone group were higher than those of the control group,and high density lipoprotein cholesterol(HDL-C)level was lower than that of the control group.The levels of TC and LDL-C in calcium oxalate calculus group were higher than those in uric acid calculus group,phosphate calculus group and synergic acid stone group,and the levels of HDL-C were lower than those in uric acid calculus group,phosphate calculus group and synergic acid stone group.The levels of TC,TG and LDL-C in uric acid stone group were higher than those in phosphate stone group and escherichtine stone group,and the levels of HDL-C were lower than those in phosphate stone group and synergic acid stone group,with statistical significance(P<0.05).Ultrasonic diagnosis of kidney stones was taken as the gold standard for diagnosis.Blood uric acid and lipid levels of all patients with kidney stones were detected and analyzed.Receiver operating characteristic(ROC)curve analysis showed that the AUC of blood uric acid,TC,TG,HDL-C and LDL-C for kidney stones detection was 0.941,0.893,0.910,0.111 and 0.638,respectively.Conclusion The serum biochemical uric acid and lipid levels are obviously abnormal in patients with kidney stones,and can show higher levels in the serum of patients with calcium oxalate stones,which has high application value in the diagnosis of kidney stones.