10140例肾结石患者临床合并症及相关因素分析

目的 评估肾结石患者的人口学分布和临床合并症特点并探索其相关因素，为临床防治提供依据。方法 回顾性分析2017年1月至2020年12月海军军医大学附属长海医院门诊及住院患者中影像学报告为肾结石的10140例患者。根据受累肾脏情况，分为单侧肾结石组(单侧组)及双侧肾结石组(双侧组),分析两组人群在年龄、性别、实验室检查、常见临床合并症上的差异，采用logistic回归探寻可能影响双侧肾结石形成的相关因素。结果 10140例肾结石患者的平均年龄为57.75±13.30岁，男女比例为2.25:1。其中单侧组8171例（80.6%），双侧组1969例（19.6%）。所有肾结石患者最常见的临床合并症依次为高血压病(HT)、肿瘤、高尿酸血症、糖尿病(DM)、冠心病(CHD)、脑血管疾病。两组在年龄、性别的分布,以及HT、肿瘤、高尿酸血症、CHD的合并率方面差异有统计学意义(P<0.05)；而在体重指数(BMI)、DM、脑血管疾病的合并率方面差异无统计学意义(P>0.05)。实验室检查方面，单侧组血清肌酐(Cr)、尿酸(UA)、尿pH值水平低于双侧组(P<0.05)；而高密度脂蛋白胆固醇(HDL-C)水平高于双侧组(P<0.05)；空腹血糖(FPG)、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平方面两组之间差异无统计学意义(P>0.05)。此外，性别(男性)、高尿酸血症可能是双侧肾结石形成的重要相关因素(P<0.05)，而合并肿瘤则更倾向于表现为单侧肾结石患者(P<0.05)。结论 肾结石更多见于中年男性，代谢综合征相关疾病在肾结石的发展过程扮演了重要角色，有必要加强这些疾患的早期防治。肾结石患者肿瘤合并率高，提示两者存在关联。此外，较单侧肾结石而言，男性、合并高尿酸血症与双侧肾结石形成关系更密切，应当引起重视。

Analysis of the clinical comorbidities and related factors in 10,140 patients with kidney stones

Objective To evaluate the demographic distribution and clinical comorbidities characteristics of kidney stone patients and explore the related factors to provide a basis for clinical prevention and treatment. Methods A retrospective analysis of 10140 patients diagnosed with kidney stones in Changhai Hospital, Naval Military Medical University between January 2017 to December 2020.According to the affected kidney condition, it was divided into unilateral kidney stone group (single-sided group) and bilateral kidney stone group (bilateral group). Analyzing the differences in age, sex distribution, laboratory examination, and common clinical comorbidities. logistic regression was used to explore the related factors that may affect the formation of bilateral kidney stones. Results The mean age of 10140 kidney stone patients was 57.75±13.30 years, with a male to female ratio of 2.25:1. Of these, 8171 patients were included in the unilateral group and 1969 patients in the bilateral group. The most common clinical complications of all patients with kidney stones are hypertension (HT), tumor, hyperuricemia, diabetes mellitus (DM), coronary heart disease (CHD), and cerebrovascular disease. There were significant differences between the two groups in the distribution of age,sex, and the pooled rate of HT, tumor, hyperuricemia, and CHD(P<0.05);However, there were no significant differences in body mass index (BMI), DM, and cerebrovascular diseases between the two groups(P>0.05)..In laboratory examination aspects, The levels of serum creatinine (Cr), uric acid (UA) and pH(urine) in the unilateral group were lower than those in the bilateral groups, showing significant difference (P<0.05), and the levels of high-density lipoprotein cholesterol (HDL-C) in the unilateral group were higher than those in bilateral groups, with significant (P<0.05);There was no significant difference in the levels of fasting blood glucose(FPG),triglyceride (TC),cholesterol (TG),and low-density lipoprotein cholesterol(LDL-C) between the two groups (P>0.05). In addition, gender (male) and hyperuricemia may be important correlated factors in the formation of bilateral kidney stones(P<0.05).However, the combined tumors tend to occur in patients with unilateral kidney stones(P<0.05) Conclusion Kidney stones are more common in middle-aged men, and metabolic syndrome-related diseases play an important role in the development process of kidney stones, so it is necessary to strengthen the early prevention of these diseases. The probability of combined tumors in patients with kidney stones is quite high, suggesting an association. In addition, compared with unilateral kidney stones, men, hyperuricemia are more closely related to the formation of bilateral kidney stones, which should be paid attention to.