尿石症危险因素人群病例对照研究

目的 探索尿石症发病的危险因素，为人群预防提供依据。方法 选取深圳市尿石症现况调查发现的334例患者为病例组，721名健康者为对照组，进行尿石症危险因素人群病例对照研究；采用非条件logistic回归对34个变量进行分析，采用Falconer回归法估算遗传变。结果 尿石症病例组和对照组配比条件均衡可比，单因素logistic回归分析共有17个变量有统计学意义，但最终进入模型的因素有10个，其中4个变量为尿石症发病危险因素，OR值大小依次为既往泌尿系慢性炎症史（OR＝4.09,95%CI:1.38-12.14)，一级亲属尿石症史（OR＝2.61,95%CI:1.70-4.01)和多食动物蛋白质（OR＝2．14，95％CI：1．71－2．69），暴露日照时间长（OR＝1．39，95％CI：1．16－1．66）；而较高文化程度（OR＝0．46，95％CI：0．29－0．73），日引水量多（OR＝0．59，95％CI：0．48－0．72），饮果汁（OR＝0．41，95％CI：0．18－0．94），多食奶及奶制品（OR＝0．82，95％CI：0．68－0．99），多食蔬菜（OR＝0．70，95％CI：0．55－0．91）和多食水果（OR＝0．78，95％CI：0．64－0．94）6个变量为尿石症发病的保护因素。一级亲属尿石症患病率病例组高于对照组，尿石症分离比为0．0109，95％CI：0．0050－0．0168，一级亲属尿石症的遗传度为28．48％，男，女分别为32．06％和24．60％。结论 尿石症主要受饮食习惯影响，尿石症家族史和社会经济状况也与发病有关。

A population-based case-control study on the risk factors of urinary calculi

Objective To determine the risk factors of urinary calculi in Shenzhen for proper interventions. Methods A population based case control study including 334 urinary calculi cases and 721 controls was carried out. A total number of 34 factors were analyzed using unconditional logistic regression. Results Seventeen factors were associated with urolithiasis based on the logistic regression analysis. Ten factors entered the last model of the logistic multivariate regression. The more protein consumption ( OR = 2.14 , 95% CI : 1.71 2.69 ), positive history of first relatives with urolithiasis( OR = 2.61 , 95% CI : 1.70 4.01 ), longer outdoor exposure( OR = 1.39 , 95% CI : 1.16 1.66 ) and chronic inflammation of urinary system( OR = 4.09 , 95% CI : 1.38 12.14 ) were risk factors of urinary calculi. Higher education background ( OR = 0.46 , 95% CI : 0.29 0.73 ), drinking more water( OR = 0.59 , 95% CI : 0.48 0.72 ), drinking more juice( OR = 0.41 , 95% CI : 0.18 0.94 ), more milk and milk product consumption ( OR = 0.82 , 95% CI : 0.68 0.99 ), vegetable ( OR = 0.70 , 95% CI : 0.55 0.91 ) and fruit consumption ( OR = 0.78 , 95% CI : 0.64 0.94) were protective factors of urolithiasis. Conclusion Dietary habits were the major influencing factors of urinary calculi. Positive history of family with urolithiasis and social economic factors were also associated with the disease.