血脂异常与上尿路结石:一项1∶2配比的相关性研究  

Association between dyslipidemia and upper urinary tract calculi:a 1∶2 matched study

作　　者：柴东岳 张桂铭[2] 翟萍 马晓诚[2] 宋鑫[1] 来庆国[1] 李浩[1] 李斌[1] 孙立江[2] 

机构地区：[1]青岛大学医学院,青岛266003 [2]青岛大学附属医院泌尿外科 [3]青岛市经济技术开发区第一人民医院血液净化科

出　　处：《临床泌尿外科杂志》2016年第5期456-458,461,共4页Journal of Clinical Urology

基　　金：山东省自然科学基金(ZR2009CM140)

摘　　要：目的：探讨血脂异常与上尿路结石发病风险的相关性。方法：回顾性分析2013年1月～2015年10月于青大附院泌尿外科住院的700例（男415例,女285例）上尿路结石患者的临床资料,按照年龄和性别配对,以1∶2配比选取同时期在青大附院健康查体中心进行体检的1 400位健康人作为对照组。收集两组人群年龄、性别、身高、体重、高血压病史、糖尿病史和血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL-c）、低密度脂蛋白（LDL-c）、尿酸（UA）等数据。应用Cox比例风险回归模型分析血脂异常与上尿路结石发病风险的相关性。结果：结石组中超重、高血压、糖尿病、尿酸水平及各血脂成分所占比例均显著高于对照组（P〈0.05）。在调整了超重、高血压、糖尿病、UA水平等因素后,Cox比例风险回归分析表明低HDL-c血症（HR=2.039,95%CI：1.583～2.627,P〈0.05）和高LDL-c血症（HR：1.556,95%CI：1.205～2.009,P〈0.05）与上尿路结石的发生显著相关。结论：上尿路结石患者中血脂异常的比例显著高于对照组,尿路结石的发生与血脂异常显著相关,低HDL-c血症和高LDL-c血症可能是上尿路结石患者发病的独立危险因素。Objective：To study the relationship between dyslipidemia and upper urinary tract calculi.Method：A 1∶2-matched for age and sex,retrospective case-control study was performed.Patients with upper urinary tract calculi were enrolled from department of urology,and controls were from the Health Examination Center at Affiliated Hospital of Qingdao University,between January 2013 and October 2015.Clinical data of 700 cases and1400controls,including age,sex,height,weight,history of hypertension or diabetes,serum levels of total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）and uric acid（UA）were collected from medical database.Stratified Cox proportional hazard regression analysis was used to study the association between dyslipidemia and upper urinary tract calculi.Result：Overweight,hypertension,diabetes,hyperuricemia and composition of dyslipidemia were prevalent in upper urinary tract calculi patients,compared with the controls（P〈 0.05）.After adjusting overweight,hypertension,diabetes and UA levels,stratified Cox proportional hazard regression analysis showed that low level of HDL-C（HR= 2.039,95%CI：1.583-2.627,P〈 0.05）and high level of LDL-C（HR = 1.556,95%CI：1.205-2.009,P〈 0.05）were significantly associated with upper urinary tract calculi.Conclusion：This study indicates that dyslipidemia is more common in patients with upper urinary tract calculi than those in control group.The occurrence of urinary stones is associated with dyslipidemia significantly.Decreased HDL-C and increased LDL-C might be risk factors for patients with upper urinary tract calculi.

关 键 词：上尿路结石 血脂异常 高密度脂蛋白胆固醇 低密度脂蛋白胆固醇 病例-对照研究 

分 类 号：R691.4[医药卫生—泌尿科学]