泌尿系结石成分分析与血脂相关性研究

目的分析泌尿系结石成分及其与血脂[甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]相关性。方法回顾性选择2014年10月～2018年10月我院收治的349例泌尿系结石患者为尿石组,同期在我院体检健康者349例为对照组,比较两组血清TG、HDL-C、TC、LDL-C水平,分析349例泌尿系结石患者泌尿系结石成分,比较血脂正常与血脂异常的泌尿系结石患者结石成分占比,采用spearman相关分析泌尿系结石成分与血脂异常的相关性,采用多因素Logistic回归分析泌尿系结石的影响因素。结果 349例泌尿系结石患者泌尿系结石成分分析结果:含钙结石270例,感染性结石51例,尿酸结石28例。尿石组血清TG、TC水平显著高于对照组(P0.05);尿石组血清HDL-C水平显著低于对照组(P0.05);尿石组血清LDL-C水平较对照组差异无统计学意义(P0.05);血脂异常泌尿系结石患者尿酸结石比例显著高于血脂正常泌尿系结石患者(P0.05);血脂异常泌尿系结石患者感染性结石、含钙结石比例较血脂正常泌尿系结石患者差异无统计学意义(P0.05);尿酸结石与血脂异常呈正相关(P0.05);感染性结石、含钙结石与血脂异常无相关性(P0.05);TG是泌尿系结石的危险因素(P0.05)。结论泌尿系结石形成与血脂水平关系密切,血脂异常尤其是高甘油三酯血症易导致尿酸结石形成,控制血脂对于预防泌尿系结石有重要临床意义。

Correlation between the composition of urinary calculi and blood lipid

Objective To analyze the composition of urinary calculus， and to determine its correlation with blood lipid related indicators ［triglycerides （TG）， total cholesterol （TC）， low density lipoprotein cholesterol （LDL?C）， high density lipoprotein cholesterol （HDL?C）］. Methods 349 cases of urinary calculus （stone group） and 349 healthy individuals （control group） in our hospital from October 2014 to October 2018 were retrospectively analyzed. Serum TG， HDL?C， TC， LDL?C levels were compared between groups， and the components of urinary stones in 349 patients were also analyzed. The composition of stones in patients with normal and abnormal blood lipid was compared. Spearman correlation was used to analyze the correlation between urinary calculus components and dyslipidemia， and multivariate Logistic regression was used to analyze the influencing factors of urinary calculus. Results The results of composition analysis of urinary stones in 349 patients showed that there were 270 cases of calcium stones， 51 cases of infectious stones and 28 cases of uric acid stones. The stone group had higher serum TG and TC levels as well as lower serum HDL?C level than those in the control group （P<0.05）， while no difference was found in the LDL?C levels between groups （P>0.05）. The proportion of uric acid stones in urinary stone patients with dyslipidemia was significantly higher than that in urinary stone patients with normal lipids （P<0.05）， while no difference was found in the proportion of infectious stones and calcium stones between patients with normal and abnormal blood lipid （P>0.05）. Uric acid stones were positively correlated with dyslipidemia （P<0.05）. There was no correlation between infectious stones， calcium stones and dyslipidemia （P>0.05）. TG was a risk factor for urinary calculi （P<0.05）. Conclusion The formation of urinary calculi is closely related to the level of blood lipid. Dyslipidemia， especially hypertriglyceridemia， can easily lead to the formation of uric acid calculi. Therefore， the control of blood lipid is of great clinical significance for the prevention of urinary calculi.