-
摘要: 目的:对结石成分进行分析,探讨结石类型与血脂代谢之间的关系。方法:回顾性分析429例泌尿系结石患者,按结石类型分为单纯草酸钙结石组、草酸钙混合结石组、磷酸钙混合结石组、尿酸结石组和其他结石组。比较不同组间患者年龄、性别、BMI、基础疾病情况、血脂检查结果的差异是否有统计学意义。对单因素分析中P<0.10的影响因素进行多分类Logistic回归分析。结果:单纯草酸钙结石238例(55.5%),草酸钙混合结石99例(23%),磷酸钙混合结石57例(13.3%),尿酸结石24例(5.6%),其他结石11例(2.6%)。不同组间患者的年龄比较差异有统计学意义(P<0.05),不同组间患者的性别、BMI、高血压和糖尿病患病情况、结石复发情况差异无统计学意义(P>0.05)。不同组间患者甘油三酯比较差异有统计学意义(P<0.05),不同组间患者的总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇比较差异无统计学意义(P>0.05)。多因素分析结果显示,与老年患者相比,青年患者的结石类型为草酸钙混合结石、磷酸钙混合结石和尿酸结石的OR(95%CI)分别为2.21(1.16~4.23)、4.53(1.83~11.24)和0.21(0.06~0.79);中年患者的结石类型为草酸钙混合结石和磷酸钙混合结石的OR(95%CI)分别为2.04(1.09~3.81)和3.29(1.33~8.14)。与正常甘油三酯患者相比,高甘油三酯患者的结石类型为草酸钙混合结石、磷酸钙混合结石和尿酸结石的OR(95%CI)分别为0.59(0.36~0.96)、0.3(0.15~0.6)和2.44(1.01~5.91)。结论:不同结石类型的患者具有明显不同的血脂代谢特点。Abstract: Objective: To identify the association between stone type and patients' lipidemia by analyzing stone composition. Method: We performed a retrospective analysis of 429 stone patients with different compositions. They were divided into 5 groups: pure calcium oxalate stone, mixed calcium oxalate stone, mixed calcium phosphate stone, uric acid stone, and other stone. Chi-square test and Fisher's exact test were carried out. Multinomial logistic analysis was applied to examine factors associated with stone type, including factors with P<0.10 in bivariate analyses. Result: Pure calcium oxalate stone(55.5%) was the most common followed by mixed calcium oxalate stone(23%), mixed calcium phosphate stone(13.3%), uric acid stone(5.6%), and other stone(2.6%). There was statistical difference in age and triglyceride among different stone type groups(P<0.05). No statistical difference in other factors among different stone type groups was identified(P>0.05). Multinomial logistic analysis showed that compared with elderly patients, the corresponding OR(95%CI) for young patients with mixed calcium oxalate stone, mixed calcium phosphate stone, and uric acid stone were 2.21(1.16-4.23), 4.53(1.83-11.24) and 0.21(0.06-0.79), for middle-aged patients with mixed calcium oxalate stone, mixed calcium phosphate stone were 2.04(1.09-3.81) and 3.29(1.33-8.14). Compared with normal triglyceride patients, the corresponding OR for high triglyceride patients with mixed calcium oxalate stone, mixed calcium phosphate stone and uric acid stone were 0.59(0.36-0.96), 0.3(0.15-0.6) and 2.44(1.01-5.91).Conclusion: Lipidemia shows a marked influence on the type of stone formation.
-
Key words:
- stone composition /
- stone type /
- lipidemia
-
-
[1] 诸骏仁,高润霖,赵水平,等.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志.2016,(10):937-953.
[2] Inci M,Demirtas A,Sarli B,et al.Association between Body Mass Index,Lipid Profiles,and Types of Urinary Stones[J].Renal Failure,2013,189(4):1359-1359.
[3] Masterson JH,Woo JR,Chang DC,et al.Dyslipidemia is associated with an increased risk of nephrolithiasis[J].Urolithiasis,2015,43(1):49-53.
[4] Kang HW,Lee SK,Kim WT,et al.Hypertriglyceridemia and Low High-Density Lipoprotein Cholesterolemia Are Associated with Increased Hazard for Urolithiasis[J].J Endourol,2014,28(8):1001-1005.
[5] Tiselius HG,Larsson L.Calcium phosphate:an important crystal phase in patients with recurrent calcium stone formation?[J].Urological Research,1993,21(3):175-180.
[6] 邓耀良,陶芝伟,王翔.含钙肾结石复发的危险因素及个体化防治策略\[J\].临床泌尿外科杂志,2018,33(2):85-88.
[7] Tiselius HG.A hypothesis of calcium stone formation:an interpretation of stone research during the past decades[J].Urological Research,2011,39(4):231-243.
[8] Tiselius HG.Who Forms Stones and Why?[J].Eur Urol Suppl,2011,10(5):408-414.
[9] 邓华,杨义,陆丽兰,等.结石类型与年龄、性别的相关性研究[J].临床泌尿外科杂志,2018,33(12):968-971.
[10] 孙朝阳,庞允,刘高杰,等.尿石红外光谱和电镜图像与尿石成因的相关性研究[J].现代泌尿外科杂志,2007,(6):368-371.
[11] Wagner CA,Mohebbi N.Urinary pH and stone formation[J].J Nephrology,2010,23 (16):S165-S169.
[12] Torricelli FC,De SK,Gebreselassie S,et al.Dyslipidemia and kidney stone risk[J].J Urol,2014,191(3):667-672.
-
计量
- 文章访问数: 206
- PDF下载数: 310
- 施引文献: 0
下载: