2015~2018年达州市尿路结石患者人口学特征及结石化学成分分析

目的对2015~2018年四川省达州地区尿路结石患者人口学特征及结石化学成分进行分析。方法选择2015年1月至2018年12月四川省达州市中西医结合医院进行治疗的583例尿路结石患者,经体外振动波碎石、手术、自排等方式获得结石标本583份进行研究。所有患者入组后均采集性别、年龄、居住地等一般资料,获取结石标本后以结石红外光谱自动分析系统对其化学成分进行分析。结果583例患者中单纯性结石289例(49.75%),二重混合性结石288例(49.40%),三重混合性结石6例(1.03%)。从结石成分分布上看草酸钙占比最高,为94.00%,其次是磷酸磷灰石37.04%、尿酸及尿酸铵14.92%。女性患者磷酸铵镁占比为4.31%,明显高于男性的1.35%(P<0.05)。其他成分不同性别患者分布情况差异无统计学意义(P>0.05)。60岁以下的患者结石成分为草酸钙占比为96.69%,明显高于60岁及以上者的89.55%(P<0.05)。其他成分不同年龄段患者分布情况差异无统计学意义(P>0.05)。城镇居民患者草酸钙、磷酸磷灰石占比分别为96.69%、40.38%,均明显高于农村居民的89.82%、28.74%(P<0.05)。其他成分不同居住环境患者分布情况差异无统计学意义(P>0.05)。结论四川达州地区尿路结石患者结石化学成分易草酸钙为主,其次为磷酸磷石灰石、尿酸及尿酸铵。不同性别、年龄、居住环境对尿路结石化学成分分布有一定的影响。

Demographic characteristics and chemical components of urinary calculi in Dazhou city from 2015 to 2018

Objective To analyze the demographic characteristics and chemical composition of urinary calculi in Dazhou area of Sichuan province from 2015 to 2018.Methods A total of 583 patients with urinary calculi who were treated in Dazhou integrated TCM&western medicine hospital from January 2015 to December 2018 were enrolled.Five hundred and eighty-three specimens of calculi were obtained by extracorporeal shock wave lithotripsy,surgery,and self-discharge.All patients were enrolled with general information such as gender,age,and place of residence.After obtaining the stone specimen,the chemical composition of the stone was analyzed by the infrared spectrum automatic analysis system.Results Among 583 patients,289(49.75%)were simple stones,288(49.40%)were double mixed stones,and 6(1.03%)were triple mixed stones.From the distribution of stone components,the highest proportion of calcium oxalate was 94.00%,followed by phosphate apatite(37.04%),uric acid and ammonium urate(14.92%).The proportion of struvite calculi in female patients was 4.31%,which was significantly higher than 1.35%in males(P<0.05).There was no significant difference in the distribution of other components with different genders(P>0.05).The proportion of calcium oxalate in the patients under 60 years old was 96.69%,which was significantly higher than 89.55%in those aged 60 years and over(P<0.05).There was no significant difference in the distribution of other components of different age groups(P>0.05).The proportion of calcium oxalate and phosphate apatite in urban residents was 96.69%and 40.38%,respectively,which were significantly higher than 89.82%and 28.74%of rural residents.There was no significant difference in the distribution of patients with other components in different living environments(P>0.05).Conclusions The chemical composition of calculi in patients with urinary tract stones in Dazhou area of Sichuan is mainly calcium oxalate,followed by phosphate phosphate limestone,uric acid and ammonium urate.Different genders,ages,and living environment have certain effects on the chemical composition of urinary tract stones.