四川省479例泌尿系结石成分分析

目的 分析四川省泌尿系结石的化学成分构成特点,为泌尿系结石的预防和治疗提供参考依据.方法 收集我院2010年12月~2012 年12 月手术取出及体外冲击波碎石后排出的泌尿系结石标本479例,采用红外光谱分析法分析结石成分,结合相应临床资料进行分析.结果 本组479例结石中,上尿路结石452例（94.4%）,下尿路结石27例（5.6%）,男312例,女167例,男女比例为1.9∶1.其中,草酸钙结石最多（54.1%）、尿酸结石（2.9%）、L-胱氨酸结石（0.6%）、六水磷酸镁铵结石（0.8%）、二水磷酸氢钙（0.2%）;草酸钙＋碳酸磷灰石结石（25.7%）、草酸钙＋尿酸（1.9%）、六水磷酸镁铵＋草酸钙（2.5%）、六水磷酸镁铵＋草酸钙＋碳酸磷灰石结石（11.3%）.男性尿酸结石明显高于女性（P＜0.05）,女性六水磷酸铵镁结石比例高于男性（P＜0.01）.结论 四川省泌尿系结石成分构成有其地域特点,即以单纯草酸钙结石为主,尿酸结石发病率低,上尿路结石远多于下尿路结石.

Composition analysis of urolithiasis for 479 cases of Sichuan Province

Objective To analyze the chemical constituents of urolithiasis in Sichuan province and to provide reference for the prevention and treatment of urolithiasis. Methods 479 samples of urolithiasis from our hospital discharged after the extracorporeal shock wave lithotripsy or removed from the inpatients through surgery from December 2010 to December 2012 were collected and analyzed with infrared spectroscopy, and the basis of relevant clinical data was analyzed. Results Among 479 cases of urolithiasis, the upper urinary tract calculus was accounted for 94. 4% （452 cases） and the lower urinary tract calculus was accounted for 5. 6% （27 cases）, 312 patients were male, 167 patients were female, the ratio of sex was 1. 9 ： 1. Calcium oxalate calculus was accounted for 54. 1 % , uric acid calculus was accounted for 2. 9% , L-cystine calculus was accounted for 0. 6% , hexahydrate magnesium ammonium phosphate calculus was accounted for 0.8% , dehydrate Calcium monohydrogen phosphate calculus was accounted for 0. 2% ,calcium oxalate ＋ carbonate calculus was accounted for 25.7% ,calcium oxalate ＋ uric acid calculus was accounted for 1. 9% ,hexahydrate magnesium ammonium phosphate ＋ calcium oxalate calculus was accounted for 2. 5% , hexahydrate magnesium ammonium phosphate ＋ calcium oxalate ＋ carbonate calculus was accounted for 11. 3%. Uric acid stones in males was significantly higher than females （P 〈 0. 05） , hexahydrate magnesium ammonium phosphate stones in females was significantly higher than in males （P 〈 0. 01 ）. Conclusion The composition of urolithiasis in Sichuan province has regional characters. Pure Calcium oxalate calculus is the major urolithiasis. The incidence of uric acid calculus is very low. The upper urinary tract calculus are far more than the lower urinary tract calculus.