小于8mm并引起梗阻及炎性反应的输尿管结石自行排出率的影响因素

目的 探讨输尿管结石引起梗阻从而导致输尿管黏膜层发生炎性反应变化对结石自行排出的影响因素。方法 通过分析小于8 mm的输尿管结石自行排出率与血清C-反应蛋白（C-reactive protein,CRP）水平和中性粒细胞百分比之间的关系,回顾2001-01至2014-01在武警新疆总队医院287例被诊断为输尿管结石且结石小于8 mm的患者。4周后通过影像学复诊判断结石是否排出。根据患者血清CRP水平分成3组,根据中性粒细胞百分比高低分成2组。分析CRP水平和中性粒细胞百分比与输尿管结石自行排出率之间的关联。结果 输尿管结石自行排出率在低血清CRP水平组、中等血清CRP水平组和高血清CRP水平组分别为：94.1%、70.0%和50.0%。输尿管结石自行排出率在正常的中性粒细胞百分比和高中性粒细胞百分比组中的通过率分别为94.5%和83.1%。结论 当输尿管结石患者血清CRP水平和中性粒细胞百分比高时,可及早考虑侵入治疗,如体外冲击波碎石术或输尿管镜碎石术。

Relationship between spontaneous passage rates of ureteral stones less than 8 mm and C-reactive protein levels and neutrophil percentages

Objective A ureter obstruction caused by a ureteral stone results in inflammatory changes in the proximal submucosal layer and prevents the spontaneous passage of the ureteral stone. Accordingly,we analyzed the relationship between the spontaneous passage rates of ureteral stones less than 8 mm in size and serum C-reactive protein（ CRP） levels and neutrophil percentages.Methods A total of 287 patients who were diagnosed as having ureteral stones less than 8 mm in size and were managed consecutively at Urological Surgery,Department Xinjiang Uigur Autonomous Regional Corps from January 2001 to January 2014 were retrospectively analyzed. Ureteral stone removal was defined as no ureteral stone shown in an imaging test for 4 weeks after diagnosis. The patients were divided into three groups according to the levels of CRP and into two groups according to neutrophil percentage. The associations between these factors and ureteral stone passage rates were then examined. Results The ureteral stone passage rates in the low serum CRP level group,the medium serum CRP level group,and the high serum CRP level group were 94. 1%,70. 0%,and 50. 0%,respectively. The passage rates of ureteral stones in the group with a normal neutrophil percentage and in the group with a higher neutrophil percentage were 94. 5% and 83. 1%,respectively. Conclusions When the CRP level and neutrophil percentage in a patient are high,aggressive treatment such as extracorporeal shock wave lithotripsy or ureteroscropy lithotripsy should be considered.