川东北地区泌尿系结石构成及其相关因素分析

目的分析川东北地区泌尿系结石的发病情况、成分以及分布特征,为其治疗及预防提供参考依据。方法回顾性分析2017年4月至2019年4月南充市中心医院收治的1564例泌尿系结石患者的结石标本,通过红外光谱分析系统对结石成分进行分析,并将患者的地域、性别、年龄、结石部位等数据进行分组,采用Excel建立数据库,进行统计学分析。结果1564例结石患者的地域分布有差异:以嘉陵区、顺庆区为多,占患者总数的17.8%和20.2%;周边地区以广安地区为多,占患者总数的9.8%。男性多于女性,二者的比例为1.42∶1。结石发病年龄分布较广:以40~59岁龄段所占构成比最高,约为53.00%。40~59岁患者主要以输尿管结石为主(52.0%,P<0.01),其次为肾结石(41.6%,P<0.01);≥60岁患者主要以肾结石为主(48.6%,P<0.01),其次是输尿管结石(40.5%)及膀胱结石(9.0%),<20岁及20~39岁年龄段结石检出率无统计学差异。结石成分:以一水草酸钙+二水草酸钙最多(29.8%,P<0.01),其次为一水草酸钙+二水草酸钙+碳酸磷灰石(20.4%,P<0.01)、无水尿酸(11.8%,P<0.01),不同年龄段及不同地区主要结石成分均有差异。结论川东北地区作为泌尿系统结石的高发地区,发病情况存在一定的年龄及地域差异,根据结石分布特点及成分分析结果,为泌尿系结石的病因诊断、治疗及预防复发提供重要的理论依据。

Analysis of urinary calculus composition and related factors in northeast Sichuan

Objective To analyze the incidence,composition and distribution of urinary calculi in northeast Sichuan,and to provide reference for the treatment and prevention.Methods A retrospective analysis of 1,564 urolithiasis patients admitted to Nanchong Central Hospital during Apr.2017 and Apr.2019 was conducted.The composition of calculi was analyzed with infrared spectrum analysis system.Patients were divided into groups according to age,region,gender and stone site.Excel database was established for statistical analysis.Results The regional distribution of patients:Shunqing District(20.2%),Jialing District(17.8%),and Guang an District(9.8%).Men outnumbered women by a ratio of 1.42 to 1.The age distribution:patients 40-59 years old accounted for the highest proportion(53.00%),with mainly ureteral calculi(52.0%,P<0.01),followed by renal calculi(41.6%,P<0.01).Patients≥60 years old mainly had renal calculi(48.6%,P<0.01),followed by ureteral calculi(40.5%)and bladder calculi(9.0%).There was no statistical difference in the detection rate between 20-year old group and 20-39-year old group.Stone composition:calcium oxalate monohydrate+calcium oxalate dihydrate was the most common(29.8%,P<0.01),followed by calcium oxalate monohydrate+calcium oxalate dihydrate+carbonate apatite(20.4%,P<0.01),and anhydrous uric acid(11.8%,P<0.01).Conclusion The incidence of urinary calculi is high in northeast Sichuan,and there are statistical differences in patients age and region.Analysis of calculi distribution and composition can provide important information for the etiology diagnosis,treatment and recurrence prevention.