河南省尿路结石成分特征分析

Analysis of Urinary Calculi Component Characteristics in Henan Province

目的总结和分析河南地区尿路结石成分的特征,为河南地区结石病的预防提供依据。方法回顾性分析郑州大学第一附属医院2017年1月至2023年12月收集的1636例来自不同患者的尿路结石样本的结石成分资料,并对其特征进行描述。结果本研究共纳入1636例患者结石成分,男女之比为2.28∶1,年龄为(45.5±14.1)岁。尿路结石主要位于上尿路,其中以肾结石为最常见,占总人群的67.5%。尿路结石在青壮年中最常见,占总人群的81.7%。尿路结石最常见的结石成分是草酸钙结石,占总人群的81.0%。不同性别结石分类构成差异有统计学意义(χ^(2)=45.476,P<0.001);草酸钙结石在男性患者中占比较高(83.2%vs 76.0%,P=0.001),而碳酸磷灰石、磷酸铵镁结石、磷酸氢钙结石在女性患者中比率较高,差异有统计学意义(P<0.05)。不同时期的结石分类构成差异有统计学意义(χ^(2)=57.542,P<0.001);近3 a磷酸铵镁结石及胱氨酸结石占比升高,草酸钙结石、碳酸磷灰石、磷酸氢钙结石占比下降,差异均有统计学意义(P<0.05)。草酸钙结石、尿酸结石和磷酸铵镁结石在不同部位差异有统计学意义(P<0.05);其中草酸钙结石在上尿路结石中常见,尿酸结石和磷酸铵镁结石在膀胱结石中更为常见。草酸钙结石、尿酸结石、磷酸氢钙结石在不同年龄段分布差异有统计学意义(P<0.05);草酸钙结石在中青年中更常见,尿酸结石在老年及儿童中更为常见,磷酸氢钙结石则在儿童中更为常见。结论河南地区尿路结石成分特征为患者性别、年龄、结石位置、不同时期均对尿路结石成分有影响,这一发现可能有助于增进对河南地区泌尿结石成分病理生理学的了解,对结石的预防提供科学依据。

Objective To summarize and analyze the characteristics of urolithiasis components in Henan,and to provide evidence for the prevention of lithiasis in Henan.Methods The calculi composition data of 1636 urinary calculi samples from different patients collected from the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2023 were retrospectively analyzed,and their characteristics were described.Results A total of 1636 patients were included in this study,the ratio of male to female was 2.28∶1,and the mean age was(45.5±14.1)years.Urinary calculi were mainly located in the upper urinary tract,among which kidney calculi were the most common,accounting for 67.5%of the total population.Urinary stones were the most common in young adults,accounting for 81.7%of the total population.The most common component of urinary calculi was calcium oxalate calculi,accounting for 81.0%of the total population.There was significant difference in classification and composition of stones between different genders(χ^(2)=45.476,P<0.001).The proportion of calcium oxalate stones was higher in male patients(83.2%vs 76.0%,P=0.001),while the proportion of apatite carbonate,magnesium ammonium phosphate and calcium hydrogen phosphate stones was higher in female patients,and the differences were statistically significant(P<0.05).The classification and composition of stones in different periods were significantly different(χ^(2)=57.542,P<0.001).In recent 3 years,the proportion of magnesium ammonium phosphate stones and cystine stones increased significantly,while the proportion of calcium oxalate stones,apatite carbonate stones and calcium hydrogen phosphate stones decreased,with statistical significance(P<0.05).The differences of calcium oxalate calculus,uric acid calculus and ammonium magnesium phosphate calculus in different parts were statistically significant(P<0.05).Calcium oxalate stones were common in upper urinary tract stones,uric acid stones and magnesium ammonium phosphate stones were more common in bladder stones.The distribution of calcium oxalate stones,uric acid stones and calcium hydrogen phosphate stones in different age groups had statistical significance(P<0.05).Calcium oxalate stones were more common in young adults,uric acid stones were more common in the elderly and children,and calcium hydrogen phosphate stones were more common in children.Conclusion The characteristics of urinary calculi components in Henan area are that gender,age,location of calculi and different periods of patients have an impact on urinary calculi components.This finding may help to improve the understanding of pathophysiology of urinary calculi components in Henan area and provide scientific basis for the prevention of calculi.