糖尿病及糖尿病前期患者上尿路结石成分的特点及其形成的影响因素分析

目的　探讨糖尿病及糖尿病前期患者上尿路结石成分的特点，并对结石成分进行相关的影响因素分析。方法　回顾性分析2015年11月至2017年9月在大连医科大学附属第二医院诊治上尿路结石患者的临床资料，比较糖尿病（DM）及糖尿病前期患者（观察组）和非糖尿病患者（对照组）之间结石成分的差异，并通过多因素Logistic回归分析相关结石形成的影响因素。结果　两组患者性别、体重指数（BMI）、血尿酸、尿液 pH等资料比较差异无统计学意义（P>0.05），空腹血糖水平和年龄比较有统计学差异（P<0.05）。观察组尿酸结石的比例明显高于对照组（P＜0.05），观察组感染性结石的比例明显低于对照组（P＜0.05）。多因素Logistic 回归分析显示糖尿病及糖尿病前期和尿液pH为尿酸结石和感染性结石形成的独立影响因素（P＜0.05）。结论　糖尿病及糖尿病前期患者较非糖尿病患者更容易患尿酸结石，非糖尿病患者较糖尿病及糖尿病前期患者更容易患感染性结石。糖尿病及糖尿病前期和尿液pH为尿酸结石和感染性结石形成的独立影响因素。

Characteristics and risk factor analysis for upper urinary tract stones in patients with diabetes and prediabetes

Objective To explore the characteristics of upper urinary tract stones in patients with diabetes and pre-diabetes, and to analyze the related factors affecting the stone components. Methods Retrospective analysis of clinical data of patients with upper urinary calculi diagnosed in the Second Affiliated Hospital of Dalian Medical University from November 2015 to September 2017 was performed to compare differences in stone composition between diabetic (DM)/pre-diabetic patients (observation group) and non-diabetic patients (control group). Then, the factors affecting the stone formation were analyzed by multivariate logistic regression. Results The clinical data of the two groups were compared and analyzed. There were no significant differences in gender, body mass index (BMI), blood uric acid and urine pH between the two groups (P>0.05), however significant differences were noticed in the fasting blood glucose level and age (P<0.05). The proportion of uric acid stones in the observation group was significantly higher than that in the control group (P<0.05). The proportion of infectious stones in the observation group was significantly lower than that in the control group (P<0.05). Multivariate logistic regression analysis revealed that diabetes/pre-diabetes and urine pH were independent factors affecting the formation of uric acid stones and infectious stones (P<0.05). Conclusion Patients with diabetes and pre-diabetes are more likely to develop uric acid stones than non-diabetic patients. Non-diabetic patients are more susceptible to infectious stones than diabetic and pre-diabetic patients. Diabetes/pre-diabetes and urine pH are independent factors affecting the formation of uric acid stones and infectious stones.