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摘要: 目的 分析遵义市上尿路结石患者的结石化学成分及结石成分在性别、年龄、结石部位间的差异，为结石防治提供依据。方法 收集2015年1月—2020年1月遵义医科大学附属医院泌尿外科治疗的1495例遵义市籍贯的上尿路结石患者的结石成分及临床资料，采用SPSS 21.0统计学软件分析结石成分与患者性别、年龄、结石部位间的差异。结果 1495例结石成分中最常见的是一水草酸钙+二水草酸钙+碳酸磷灰石，其次是一水草酸钙结石。男性尿酸结石所占比例高于女性，而女性碳酸磷灰石及磷酸镁铵结石比例高于男性(P< 0.01)。尿酸结石随着年龄增长而增加(P< 0.05)。结论 遵义地区上尿路结石成分以草酸钙结石为主，尿酸结石发病率亦不容忽视，结石成分在性别、年龄间存在差异，这对不同成分结石的防治提供了一定的依据。Abstract: Objective To analyze the chemical composition of upper urinary calculi in Zunyi City and the differences of stone composition in gender, age, stone location, and to provide basis for the prevention and treatment of stones.Methods Clinical data of 1495 patients with identified upper urinary calculi living in Zunyi City admitted to the Affiliated Hospital of Zunyi Medical University from January 2015 to January 2020 were collected. The differences between stone composition and related factors were analyzed by SPSS 21.0 statistical software.Results Among 1495 cases, the most dominant composition was calcium oxalate monohydrate + calcium oxalate dihydrate + carbonate apatite, followed by calcium oxalate monohydrate stone. The proportion of men with uric acid stones is higher than that of women, while women's carbonate apatite and magnesium ammonium phosphate stones are more than men's (P< 0.01). The higher the age was, the higher the detection rate of uric acid stones was (P< 0.05).Conclusion Calcium oxalate stones are the main components of upper urinary tract stones in Zunyi City, but the incidence of uric acid stones cannot be ignored. There are differences in stone composition in gender, age, which provides a basis for prevention and control of different types of stones.
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Key words:
- upper urinary stones /
- infrared spectrometer /
- stone composition
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表 1 上尿路结石成分在不同年龄、性别分布情况
例(%) 结石成分 年龄 性别 合计 18~40岁 41~65岁 ≥66岁 男 女 一水草酸钙 61(17.9) 195(22.4) 65(22.8) 218(25.4) 103(16.1) 321 无水尿酸 7(2.1) 21(2.4) 11(3.9) 28(3.3) 11(1.7) 39 碳酸磷灰石 5(1.5) 5(0.6) 2(0.7) 6(0.7) 6(0.9) 12 六水磷酸镁铵 4(1.2) 3(0.3) 1(0.4) 0 8(1.3) 8 一水草酸钙+二水草酸钙+碳酸磷灰石 111(32.3) 222(25.5) 59(20.7) 205(23.9) 187(29.3) 392 一水草酸钙+二水草酸钙 72(21.2) 139(16.0) 57(20.0) 165(19.3) 103(16.1) 268 一水草酸钙+碳酸磷灰石 38(11.2) 130(14.9) 45(15.8) 101(11.8) 112(17.6) 213 无水尿酸+一水草酸钙 18(5.3) 82(9.4) 20(7.0) 78(9.1) 42(6.6) 120 一水草酸钙+二水草酸钙+碳酸磷灰石+六水磷酸镁铵 5(1.5) 25(2.9) 9(3.2) 14(1.6) 25(3.9) 39 尿酸铵+一水草酸钙 12(3.5) 14(1.6) 5(1.8) 26(3.0) 5(0.8) 31 一水草酸钙+碳酸磷灰石+六水磷酸镁铵 3(0.9) 9(1.0) 6(2.1) 1(0.1) 17(2.7) 18 六水磷酸镁铵+碳酸磷灰石 3(0.9) 8(0.9) 1(0.4) 6(0.7) 6(0.9) 12 一水草酸钙+二水磷酸氢钙 0 8(0.9) 2(0.7) 5(0.6) 5(0.8) 10 二水草酸钙+碳酸磷灰石 1(0.3) 5(0.6) 0 2(0.2) 4(0.6) 6 六水磷酸镁铵+碳酸磷灰石+尿酸铵 0 4(0.5) 2(0.7) 2(0.2) 4(0.6) 6 合计 340 870 285 857 638 1495 
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表 2 不同性别、年龄、结石部位患者结石成分的比较
例(%) 项目 例数 结石成分 χ2 P值 草酸钙结石 尿酸结石 碳酸磷灰石 磷酸镁铵结石 磷酸氢钙结石 性别 65.804 < 0.01 男 857 633(73.9) 135(15.8) 61(7.1) 16(1.9) 12(1.4) 女 638 428(67.1) 61(9.6)1) 95(14.9)1) 50(7.8)1) 4(0.6) 年龄 16.42 < 0.05 18~40岁 340 242(71.2) 41(12.1) 44(12.9) 12(3.5) 1(0.3) 41~65岁 1067 763(71.5) 139(13.0) 106(9.9) 47(4.4) 15(1.4) ≥66岁 88 56(63.6) 19(21.6)1) 6(6.8)1) 7(8.0) 0 部位 5.998 > 0.05 肾脏 987 681(69.0) 136(13.8) 113(11.4) 45(4.6) 12(1.2) 输尿管 508 380(74.8) 60(11.8) 43(8.5) 21(4.1) 4(0.8) 注：1)P < 0.05。
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[1] Cho ST, Jung SI, Myung SC, et al. Correlation of metabolic syndrome with urinary stone composition[J]. Int J Urol, 2013, 20(2): 208-213. doi: 10.1111/j.1442-2042.2012.03131.x
[2] Grant C, Guzman G, Stainback RP, et al. Variation in Kidney Stone Composition Within the United States[J]. J Endourol, 2018, 32(10): 973-977. doi: 10.1089/end.2018.0304
[3] 董浩, 王琦, 彭泳涵, 等. 泌尿系上尿路结石成分的单中心研究[J]. 第二军医大学学报, 2018, 39(4): 450-454. https://www.cnki.com.cn/Article/CJFDTOTAL-DEJD201804018.htm
[4] 孙业峰, 张志磊, 曹源超, 等. 单中心483例泌尿系结石成分分析及临床意义[J]. 青岛大学学报(医学版), 2021, 57(5): 675-678. https://www.cnki.com.cn/Article/CJFDTOTAL-BATE202105016.htm
[5] 廖陈曾, 胡敬祖, 陈晓波, 等. 宜昌地区817例泌尿系结石成分和发病特点分析[J]. 巴楚医学, 2021, 4(4): 107-110. doi: 10.3969/j.issn.2096-6113.2021.04.023
[6] 吴伟宙, 黄健, 梁雄发, 等. 单中心15269例泌尿系结石患者的结石成分分析[J]. 中华泌尿外科杂志, 2018.39(9): 651-655. doi: 10.3760/cma.j.issn.1000-6702.2018.09.004
[7] 高逢彬, 王谦, 王荣江, 等. 浙江省泌尿系结石患者的结石成分分析(附4423例报告)[J]. 中华泌尿外科杂志, 2019, 40(8): 619-624. doi: 10.3760/cma.j.issn.1000-6702.2019.08.013
[8] Carbone A, Al Salhi Y, Tasca A, et al. Obesity and kidney stone disease: a systematic review[J]. Minerva UrolNefrol, 2018, 70(4): 393-400.
[9] 何群, 张晓春, 那彦群. 284例泌尿系结石成分分析与代谢评价[J]. 中华泌尿外科杂志, 2005, 26(11): 761-764. doi: 10.3760/j:issn:1000-6702.2005.11.013
[10] 黄韬, 龙兆麟, 吴世皓, 等. 顺德地区3257例尿石症住院患者分析[J]. 医学信息(中旬刊), 2010, 5(4): 775-776. doi: 10.3969/j.issn.1006-1959.2010.04.028
[11] 宋鹏, 梁培育, 李浩勇. 海南省119例尿路结石化学成分分析[J]. 海南医学院学报, 2011, 17(3): 374-376, 379. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYY201103032.htm
[12] 罗千旋, 刘云龙, 刘权, 等. 几种茶对大鼠草酸钙结石的影响[J]. 世界最新医学信息文摘(连续型电子期刊), 2020, 20(45): 147-150.
[13] Wu ZB, Jiang T, Lin GB, et al. Tea consumption is associated with increased risk of kidney stones in Northern Chinese: a crosssectional study[J]. Biomed Environ Sci, 2017, 30(12): 922-926.
[14] Shu X, Cai H, Xiang YB, et al. Green tea intake and risk of incident kidney stones: Prospective cohort studies in middle-aged and elderly Chinese individuals[J]. Int J Urol, 2019, 26(2): 241-246. doi: 10.1111/iju.13849
[15] Zhuo D, Li M, Cheng L, et al. A Study of Diet and Lifestyle and the Risk of Urolithiasis in 1, 519 Patients in Southern China[J]. Med Sci Monit, 2019, 25: 4217-4224. doi: 10.12659/MSM.916703
[16] Barghouthy Y, Corrales M, Doizi S, et al. Tea and coffee consumption and pathophysiology related to kidney stone formation: a systematic review[J]. World J Urol, 2021, 39(7): 2417-2426. doi: 10.1007/s00345-020-03466-8
[17] 黄秋洁, 王韬, 景立新, 等. 贵州省尿石症高发地区水质分析研究[J]. 中国卫生检验杂志, 2012, 22(1): 76-77, 80. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWJZ201201032.htm
[18] 石华, 徐述雄, 李凯, 等. 贵州省708例尿路结石成分分析[J]. 第三军医大学学报, 2013, 35(7): 657-660. https://www.cnki.com.cn/Article/CJFDTOTAL-DSDX201307023.htm
[19] Al Zahrani H, Norman RW, Thompson C, et al. The dietary habits of idiopathic calcium stone-formers and normal control subjects[J]. BJU Int, 2000, 85(6): 616-620.
[20] 周尔松. 遵义市汇川区地下水水质时空变化及评价[J]. 开封教育学院学报, 2016, 36(7): 283-284. doi: 10.3969/j.issn.1008-9640.2016.07.130
[21] 张世旭, 王中美, 代天豪. 毕节地区岩溶地下水水化学特征与水质评价[J]. 长江科学院院报, 2019, 36(5): 28-33, 41. https://www.cnki.com.cn/Article/CJFDTOTAL-CJKB201905009.htm
[22] Panhwar AH, Kazi TG, Afridi HI, et al. Evaluation of calcium and magnesium in scalp hair samples of population consuming different drinking water: risk of kidney stone[J]. Biol Trace Elem Res, 2013, 156(1-3): 67-73. doi: 10.1007/s12011-013-9850-1
[23] Caudarella R, Rizzoli E, Buffa A, et al. Comparative study of the influence of 3 types of mineral water in patients with idiopathic calcium lithiasis[J]. J Urol, 1998, 159(3): 658-663. doi: 10.1016/S0022-5347(01)63695-4
[24] Mirzazadeh M, Nouran M, Richards K, et al. Effects of drinking water quality on urinary parameters in men with and without urinary tract stones[J]. Urology, 2012, 79(3): 501-507. doi: 10.1016/j.urology.2011.10.025
[25] SulaimanSK, EnaksheeJ, TraxerO, et al. Which type of water is recommended for patients with stone disease(hard or soft water, tap or bottled water): evidence from a systematic review over the last 3 decades[J]. CurrUrol Rep, 2020, 21(1): 6.
[26] Ye Z, Zeng G, Yang H, et al. The status and characteristics of urinary stone composition in China[J]. BJU Int, 2020, 125(6): 801-809. doi: 10.1111/bju.14765
[27] 唐寅, 程鸿明, 王坤杰, 等. 四川省243例泌尿系结石成分及相关因素分析[J]. 现代泌尿外科杂志, 2016, 21(1): 27-30. doi: 10.3969/j.issn.1009-8291.2016.01.008
[28] 王起, 杨波, 徐涛, 等. 代谢综合征与尿酸结石成分的相关性研究[J]. 中华泌尿外科杂志, 2016, 37(8): 583-585. doi: 10.3760/cma.j.issn.1000-6702.2016.08.005
[29] Li R, Li W, Lun Z, et al. Prevalence of metabolic syndrome in Mainland China: a meta-analysis of published studies[J]. BMC Public Health, 2016, 16: 296. doi: 10.1186/s12889-016-2870-y
[30] 孙东瑞, 顾晓, 赵静燕, 等. 扬州地区838例泌尿系结石成分及相关因素分析[J]. 临床泌尿外科杂志, 2021, 36(10): 776-781, 784. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW202110004.htm
[31] 高逢彬, 金讯波, 崔子连. 泌尿系感染性结石的成因及诊治现状[J/OL]. 泌尿外科杂志(电子版), 2015, 7(4): 51-54.
[32] 苏晓伟, 王大明, 丁德茂, 等. 感染性结石的相关临床易感因素研究[J]. 临床泌尿外科杂志, 2021, 36(4): 284-287. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW202104008.htm
[33] Foxman B, Brown P. Epidemiology of urinary tract infections: transmission and risk factors, incidence, and costs[J]. Infect Dis Clin North Am, 2003, 17(2): 227-241. doi: 10.1016/S0891-5520(03)00005-9
[34] 郭震华, 那彦群. 实用泌尿外科学[M]. 北京: 人民卫生出版社, 2013: 174.
[35] Costa-Bauzá A, Ramis M, Montesinos V, et al. Type of renal calculi: variation with age and sex[J]. World J Urol, 2007, 25(4): 415-421. doi: 10.1007/s00345-007-0177-4
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| 引用本文: |
涂熹, 庄稀尧, 黄朝友, 等. 1495例上尿路结石成分分析单中心研究[J]. 临床泌尿外科杂志, 2022, 37(5): 364-368. doi: 10.13201/j.issn.1001-1420.2022.05.007
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| Citation: |
TU Xi, ZHUANG Xiyao, HUANG Chaoyou, et al. Analysis on the component of 1495 upper urinary calculi: a single-center study[J]. J Clin Urol, 2022, 37(5): 364-368. doi: 10.13201/j.issn.1001-1420.2022.05.007
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