超重和肥胖对肾结石成分的影响  

Chemical composition of kidney stones in overweight/obese patients

作　　者：潘慧仙 诸靖宇[1] 李瑞鹏[1] 周鹏[1] 倪庆节[1] 宋晨[1] 王彦彬[1] 楼扬锋 

机构地区：[1]杭州市第三人民医院泌尿外科,310009

出　　处：《浙江医学》2016年第13期1093-1095,共3页Zhejiang Medical Journal

基　　金：杭州市医疗卫生科研项目(20140633B14)

摘　　要：目的探讨超重和肥胖对肾结石成分的影响。方法选择2010年11月至2015年3月住院治疗的960例肾结石患者为研究对象,根据不同BMI分为体重正常组450例、超重组280例和肥胖组230例;收集患者结石标本进行红外光谱结石成分分析,并比较不同BMI组患者的结石成分。结果超重、肥胖组尿液p H值均低于体重正常组(均P<0.05),而血尿酸浓度均高于体重正常者(均P<0.05);超重、肥胖组结石最大直径与体重正常组比较,差异均无统计学意义(均P>0.05)。超重、肥胖组患者结石含有尿酸成分的比例均高于体重正常组(均P<0.05),含有草酸钙成分的比例均低于体重正常组(均P<0.05);而感染性结石成分(磷酸铵镁+碳酸钙磷灰石)、磷酸钙(羟磷灰石+透磷钙石)和胱氨酸成分,超重组、肥胖组分别与体重正常组比较,差异均有统计学意义(均P>0.05)。结论 BMI偏高的结石患者尿液p H值较低,血尿酸浓度较高,结石中尿酸成分的比例较高;建议控制患者体重,针对尿酸成分进行相关预防与治疗。Objective To examine chemical composition of kidney stones in overweight/obese patients.Methods total of960 patients with nephrolithiasis admitted from November 2010 to March 2015 were included in this study.The age,weight,height and gender were documented,and their blood and urine samples were tested.The chemical composition of urinary stone specimens were analyzed by infrared spectra.Results Of 960 patients 510 were identified as overweight/obesity（BMI≥25kg/m^2）and the others as normal weight.Urinary pH values of patients with overweight/obesity group was significantly lower than that of patients with normal BMI（P〈0.05）.Moreover,the concentration of serum uric acid in overweight/obesity group was markedly higher than that in normal BMI group（P〈0.05）.Infrared analysis demonstrated that 26.9%of stonesfrom overweight/obesity group contained uric acid,while only 11.1%from normal BMI group had uric acid（P〈0.05）.The percentage of stones containing calcium oxalate in overweight/obese group was lower（P〈0.05）.Conclusion In overweight and obese patients with nephrolithiasis,serum uric acid levels are increased and higher percentage of their kidney stones contains uric acid,and strategies targeting uric acid stones should be taken inthose patients.

关 键 词：肾结石 BMI 结石成分 尿酸 红外光谱分析 

分 类 号：R692.4[医药卫生—泌尿科学] R589.2[医药卫生—外科学]