延安地区泌尿系结石成分分析的研究

目的利用红外光谱法测定延安大学附属医院泌尿外科手术获得的泌尿系结石成分,探讨延安地区泌尿系结石成分与年龄、性别等关系,比较上、下尿路结石成分特点,分析延安地区泌尿系结石发生的流行病学情况,为临床制定有效的个体化治疗及预防措施提供参考依据。方法收集2013年1月至2017年1月在延安大学附属医院泌尿外科治疗1984例尿路结石患者的年龄、性别、结石部位等临床资料,对比分析延安地区泌尿系结石在不同年龄、不同性别、不同解剖部位的分布特点。结果在1984例泌尿系结石的患者中,按每10岁年龄大小分组排序,统计各年龄阶段泌尿系结石发病情况,男性患者有1346例,女性患者有638例,男性年龄(50.23±14.48)岁,女性年龄(47.87±14.51)岁,男、女患者比例约2.11∶1。在66~75岁年龄段,尿路结石发病率性别差异具有统计学意义(P<0.05)。结石成分以混合性结石为主,以混合性结石为主,共1582例,占79.76%。其中1665例(83.92%)为上尿路结石,上、下尿路结石的比例为5.22∶1,其余为肾结石合并膀胱结石。上尿路结石中男性1062例,女性603例,男女比例为1.76∶1;下尿路结石中男性284例,女性35例,男女比例为8.11∶1。青壮年(年龄≤45岁)泌尿系结石患者草酸钙为主结石、感染性结石多见;中老年(年龄>45岁)泌尿系结石者草酸钙为主结石、尿酸类结石多见。感染性结石患者性别差异具有统计学意义(P<0.05)。结论在延安地区男性较女性更容易患泌尿系结石。同时,不同年龄段结石构成成分具有差异。对于年龄≤45岁患者,主要以草酸钙为主结石、感染性结石多见,这与结石整体发病率基本一致;而对于年龄>45岁患者,主要以草酸钙为主结石、尿酸性结石多见。表明对于不同年龄段的结石患者,可以根据上述结果在结石的预防和治疗上综合考量,给予明确而更加合理的治疗。

The composition analysis of urinary calculi in Yan'an area

Objective To measure the urinary stones composition that acquired in urological surgery of Yan'an university affiliated hospital using infrared spectroscopy,`and to explore the relations between the composition of urinary stones and patients'age,gender,compare the upper and lower urinary tract stones component characteristics,analyze the epidemiological situation of urinary stones in Yan'an area,provide effective individualized treatments and preventive measures for clinic.Methods A total of 1984 cases of urinary calculi were collected from January 2013 to January 2017 in the department of urology,and the distribution characteristics of urinary calculi in different ages,sexes and anatomical sites were compared and analyzed.SPSS 20.0 software,Chi-square test and Fishers exact probability method were used for statistical analysis,the difference was statistically significant(P<0.05).Results In 1984 cases of urinary calculi,the incidence of urinary calculi was classified according to the age of 10 years.There were 1346 cases in males and 638 cases in females.The average age of males(50.23±14.48)years,females(47.87±14.51)years.At the age of 66-75,the incidence of urinary calculi was gender difference(P<0.05).The main composition of the stones was mixed stones,mainly of mixed stones,accounting for 79.76%(1582 cases).Among them,1665 cases(83.92%)were upper urinary calculi,the ratio of upper urinary calculi to lower urinary calculi was 5.22∶1,and the other one was renal calculi with bladder calculi.There were 1062 males and 603 females in upper urinary tract calculi,the ratio of males and females was 1.76∶1,and 284 males and 35 females in lower urinary tract calculi,the ratio of males and females was 8.11∶1.Calcium oxalate calculi and infectious calculi were common in young and middle-aged(age≤45 years)patients with urinary calculi,while calcium oxalate calculi and uric acid calculi were common in middle-aged and elderly(age>45 years)patients with urinary calculi.The gender difference in patients with infectious stones was statistically significant(P<0.05).Conclusions In Yan'an men are more likely to have urinary calculi than women.At the same time,the composition of calculi is different in different age groups.For patients under 45 years old,mainly calcium oxalate as the main stone,infectious stones are more common,which is basically consistent with the overall incidence of stones.For patients over 45 years old,mainly calcium oxalate-based calculi,uric acid calculi are more common.This conclusion indicates that for patients with calculi of different ages,the prevention and treatment of calculi can be comprehensively considered according to the above results,and a clear and more reasonable treatment can be given.