1843例泌尿系结石患者结石成分分析
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摘要
目的分析桂北地区泌尿系结石患者发病情况及结石成分特点,并研究个体化饮食预防指导对结石复发的临床意义。方法收集2011年6月至2017年12月该院1 843例泌尿系结石患者的结石标本,采用红外光谱法分析结石成分;对2015年1月至2016年12月出院的520例患者进行随访,其中242例给予饮食预防指导(观察组),278例未给予饮食预防指导(对照组),1年后随访,比较两组复发率。结果 1 843例泌尿系结石患者中男女患者比例为2.01∶1.00;中年患者(41～65岁)所占比例最高(67.66%);少年(<18岁)、青年(18～<41岁)、中年(41～65岁)患者以肾结石为主,老年患者(>65岁)以膀胱结石为主;一水草酸钙+碳酸磷灰石+二水草酸钙组成的混合结石所占比例最高(28.90%);随访患者中,观察组结石复发率(6.61%)较对照组结石复发率(23.38%)低,差异有统计学意义(P<0.05)。结论桂北地区尿路结石患者主要为男性、中年患者,主要结石成分为草酸钙结石,个体化饮食预防指导可有效降低结石的复发风险。
Objective To analyze the incidence and characteristics of calculi components in patients with urinary calculi in northern Guangxi,and to investigate the clinical significance of individualized dietary prevention guidance for the recurrence urinary calculi.Methods A total of 1 843 calculi specimens were collected from patients with urinary calculi treated in this hospital from June 2011 to December 2017,and calculi components were detected by infrared spectroscopy.A total of 520 cases of patients who discharged from January2015 to December 2016 were followed up,of which 242 cases were given dietary prevention guidance(the observation group),and the other 278 cases were not given dietary prevention guidance(the control group).After 1 year follow-up,the recurrence rate was compared between the two groups.Results The ratio of male to female patients was 2.01∶1.00;the proportion of middle-aged patients(41-65 years old)was the highest(67.66%).The juveniles(<18 years old),young people(18-<41 years old)and the middle-aged(41-65 years old)patients mainly were diagnosed with kidney stones,while the elderly patients(>65 years old)was mainly diagnosed with bladder stones.The mixed stones composed of calcium oxalate monohydrate,carbonate apatite and calcium oxalate dihydrate were accounted for the highest proportion(28.90%).Among the followup patients,the recurrence rate of urinary calculi in the observation group(6.61%)was lower than that in the control group(23.38%),the difference was statistically significant(P<0.05).Conclusion Urinary calculi in the northern of Guangxi are mainly male and middle-aged patients.The main calculi component is calcium oxalate stone.Individualized dietary prevention guidance can effectively reduce the risk of urinary calculi recurrence.
Objective To analyze the incidence and characteristics of calculi components in patients with urinary calculi in northern Guangxi,and to investigate the clinical significance of individualized dietary prevention guidance for the recurrence urinary calculi.Methods A total of 1 843 calculi specimens were collected from patients with urinary calculi treated in this hospital from June 2011 to December 2017,and calculi components were detected by infrared spectroscopy.A total of 520 cases of patients who discharged from January2015 to December 2016 were followed up,of which 242 cases were given dietary prevention guidance(the observation group),and the other 278 cases were not given dietary prevention guidance(the control group).After 1 year follow-up,the recurrence rate was compared between the two groups.Results The ratio of male to female patients was 2.01∶1.00;the proportion of middle-aged patients(41-65 years old)was the highest(67.66%).The juveniles(<18 years old),young people(18-<41 years old)and the middle-aged(41-65 years old)patients mainly were diagnosed with kidney stones,while the elderly patients(>65 years old)was mainly diagnosed with bladder stones.The mixed stones composed of calcium oxalate monohydrate,carbonate apatite and calcium oxalate dihydrate were accounted for the highest proportion(28.90%).Among the followup patients,the recurrence rate of urinary calculi in the observation group(6.61%)was lower than that in the control group(23.38%),the difference was statistically significant(P<0.05).Conclusion Urinary calculi in the northern of Guangxi are mainly male and middle-aged patients.The main calculi component is calcium oxalate stone.Individualized dietary prevention guidance can effectively reduce the risk of urinary calculi recurrence.
引文
[1]吴阶平.吴阶平泌尿外科学[M].济南:山东科学技术出版社,2005:715-755.
[2]徐勋,赵振华,石明,等.1 168例泌尿系结石患者结石成分分析及其饮食预防指导[J].临床泌尿外科杂志,2014,29(8):694-696.
[3] SCALES J,SMITH A C,HANLEY J M,et al.Prevalence of kidney stones in the United States[J].Eur Urol,2012,62(1):160-165.
[4]曾国华,麦赞林,夏术阶,等.中国成年人群尿石症患病率横断面调查[J].中华泌尿外科杂志,2015,36(7):528-532.
[5]王施广,王娟,王振,等.泌尿系结石的流行病学研究进展[J].现代生物医学进展,2016,16(3):597-600,592.
[6]朱蜀侠,王宇,胥艳,等.川西地区500例泌尿系结石成分构成及相关因素分析[J].临床泌尿外科杂志,2014,29(4):337-341.
[7]石华,徐述雄,李凯,等.贵州省708例尿路结石成分分析[J].第三军医大学学报,2013,35(7):657-660.
[8] MILLER N L,EVAN A P,LINGEMAN J E.Pathogenesis of renal calculi[J].Urol Clin North Am,2007,34(3):295-313.
[9] RICCHIUTI V,HARTKE D M,YANG L Z,et al.Levels of urinary inter-alpha-trypsin inhibitor trimer as a function of age and sex-hormone status in males and females not forming stones[J].BJU Int,2002,90(6):513-517.
[10]何群,张晓春,那彦群.284例泌尿系结石成分分析与代谢评价[J].中华泌尿外科杂志,2005,26(11):761-764.
[11]郑嘉欣,刘春晓,张开颜,等.闽西南地区861例泌尿系结石患者的结石成分分析[J].山东医药,2014,58(13):31-33.
[12]COSTA-BAUZA,RAMIS M,MONTESINOS V,et al.Type of renal calculi:variation with age and sex[J].World J Urol,2007,25(4):415-421.
[13]吴韶,姚春红.睾酮、雌二醇水平变化与泌尿系结石形成的关系[J].医学信息(上旬刊),2011,24(12):300-301.
[14]SHAFI H,SHAHANDEH Z,HEIDARI B,et al.Bacteriological study and structural composition of staghorn stones removed by the anatrophic nephrolithotomic procedure[J].Saudi J Kidney Dis Transpl,2013,24(2):418-423.
[15]ALAYA A,NOURI A,BELGITH M,et al.Changes in urinary stone composition in the Tunisian population:a retrespective study of 1 301cases[J].Ann Lab Med,2012,32(3):177-183.
[16]BRIKOWSKI T H,LOTAN Y,PEARLE M S.Climaterelated increase in the prevalence of urolithiasis in the United States[J].Proc Natl Acad Sci U S A,2008,105(28):9841-9846.
[17]STRAUB M,HAUTMANN R E.Developments in stone prevention[J].Curr Opin Urol,2005,15(2):119-126.
[18]林杰,罗莉,袁丽琼,等.渝东南地区尿路结石成分及特点分析[J].重庆医学,2015,44(26):3652-3654,3657.
[19]PRASONGWATANA V,BOVORNPADUNGKITTI S,CHOTIKAWANICH E,et al.Chemical components of urinary stones according to age and sex of adult patients[J].J Med Assoc Thai,2008,91(10):1589-1594.
[20]管旌旌,胡敬海,王晓庆,等.吉林省老年肾结石患者结石成分分析[J].中国老年学杂志,2012,32(11):2270-2271.
[2]徐勋,赵振华,石明,等.1 168例泌尿系结石患者结石成分分析及其饮食预防指导[J].临床泌尿外科杂志,2014,29(8):694-696.
[3] SCALES J,SMITH A C,HANLEY J M,et al.Prevalence of kidney stones in the United States[J].Eur Urol,2012,62(1):160-165.
[4]曾国华,麦赞林,夏术阶,等.中国成年人群尿石症患病率横断面调查[J].中华泌尿外科杂志,2015,36(7):528-532.
[5]王施广,王娟,王振,等.泌尿系结石的流行病学研究进展[J].现代生物医学进展,2016,16(3):597-600,592.
[6]朱蜀侠,王宇,胥艳,等.川西地区500例泌尿系结石成分构成及相关因素分析[J].临床泌尿外科杂志,2014,29(4):337-341.
[7]石华,徐述雄,李凯,等.贵州省708例尿路结石成分分析[J].第三军医大学学报,2013,35(7):657-660.
[8] MILLER N L,EVAN A P,LINGEMAN J E.Pathogenesis of renal calculi[J].Urol Clin North Am,2007,34(3):295-313.
[9] RICCHIUTI V,HARTKE D M,YANG L Z,et al.Levels of urinary inter-alpha-trypsin inhibitor trimer as a function of age and sex-hormone status in males and females not forming stones[J].BJU Int,2002,90(6):513-517.
[10]何群,张晓春,那彦群.284例泌尿系结石成分分析与代谢评价[J].中华泌尿外科杂志,2005,26(11):761-764.
[11]郑嘉欣,刘春晓,张开颜,等.闽西南地区861例泌尿系结石患者的结石成分分析[J].山东医药,2014,58(13):31-33.
[12]COSTA-BAUZA,RAMIS M,MONTESINOS V,et al.Type of renal calculi:variation with age and sex[J].World J Urol,2007,25(4):415-421.
[13]吴韶,姚春红.睾酮、雌二醇水平变化与泌尿系结石形成的关系[J].医学信息(上旬刊),2011,24(12):300-301.
[14]SHAFI H,SHAHANDEH Z,HEIDARI B,et al.Bacteriological study and structural composition of staghorn stones removed by the anatrophic nephrolithotomic procedure[J].Saudi J Kidney Dis Transpl,2013,24(2):418-423.
[15]ALAYA A,NOURI A,BELGITH M,et al.Changes in urinary stone composition in the Tunisian population:a retrespective study of 1 301cases[J].Ann Lab Med,2012,32(3):177-183.
[16]BRIKOWSKI T H,LOTAN Y,PEARLE M S.Climaterelated increase in the prevalence of urolithiasis in the United States[J].Proc Natl Acad Sci U S A,2008,105(28):9841-9846.
[17]STRAUB M,HAUTMANN R E.Developments in stone prevention[J].Curr Opin Urol,2005,15(2):119-126.
[18]林杰,罗莉,袁丽琼,等.渝东南地区尿路结石成分及特点分析[J].重庆医学,2015,44(26):3652-3654,3657.
[19]PRASONGWATANA V,BOVORNPADUNGKITTI S,CHOTIKAWANICH E,et al.Chemical components of urinary stones according to age and sex of adult patients[J].J Med Assoc Thai,2008,91(10):1589-1594.
[20]管旌旌,胡敬海,王晓庆,等.吉林省老年肾结石患者结石成分分析[J].中国老年学杂志,2012,32(11):2270-2271.