浙江省泌尿系结石患者的结石成分分析(附4 423例报告)  

Urinary stone composition analysis of 4 423 cases in Zhejiang province

作　　者：高逢彬 王谦 王荣江[3] 余燕岚[1] 俞世成[1] 陈艺成[1] 饶大庞[2] 马亮[1] 吴海洋[1] 李恭会[1] 丁国庆[1] Gao Fengbin;Wang Qian;Wang Rongjiang;Yu Yanlan;Rui Xuefang;Yu Shicheng;Chen Yicheng;Rao Dapang;Ma Liang;Wu Haiyang;Li Gonghui(Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China;Department of Urology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China;Department of Urology, Huzhou First People's Hospital, Huzhou 313000, China)

机构地区：[1]浙江大学医学院附属邵逸夫医院泌尿外科,杭州310016 [2]温州医科大学附属第二医院泌尿外科,温州325000 [3]湖州市第一人民医院泌尿外科,湖州313000

出　　处：《中华泌尿外科杂志》2019年第8期619-624,共6页Chinese Journal of Urology

基　　金：浙江省科技厅公益技术研究社会发展项目(2016C33135).

摘　　要：目的探讨浙江省泌尿系结石患者的结石成分特点及浙南和浙北两地区间结石成分分布差异。方法回顾性分析2012年10月至2018年10月浙江大学医学院附属邵逸夫医院、温州医科大学附属第二医院及湖州市第一人民医院行结石成分分析的4 423例泌尿系结石患者的临床资料。男3 041例,女1 382例。年龄(51.2±16.5)岁。其中,浙北地区2 974例,浙南地区1 449例。高发年龄段为41~60岁,占48.2%(2 136/4 423)。分析不同性别、年龄、地域患者的结石成分分布差异。结果4 423例中混合成分结石占多数,为73.1%(3 235/4 423),其中以一水草酸钙+二水草酸钙+碳酸磷灰石最多,占36.2%(1 604/4 423);单一成分结石中以一水草酸钙结石最多,占16.3%(719/4 423)。女性较男性的碳酸磷灰石[70.1%(970/1 382)与61.0%(1 856/3 041),P<0.05]及磷酸铵镁结石比例[12.7%(176/1 382)与4.9%(150/3 041),P<0.05]明显升高,而男性较女性的尿酸结石比例[10.6%(325/3 041)与5.8%(81/1 382), P<0.05]明显升高。0~40岁较>60岁患者草酸钙[90.6%(961/1 060)与76.2%(935/1 227),P<0.05]、碳酸磷灰石[77.6%(823/1 060)与50.7%(623/1 227),P<0.05]及磷酸铵镁结石[9.1%(97/1 060)与6.5%(80/1 227),P<0.05]比例明显升高,而尿酸结石比例明显降低[3.5%(38/1060)与17.0%(209/1 227),P<0.05]。浙南地区草酸钙结石比例低于浙北地区[79.0%(1 145/1 449)与89.4%(2 661/2 974),P<0.05],而碳酸磷灰石结石[71.5%(1 037/1 449)与60.1%(1 789/2 974),P<0.05]、磷酸铵镁结石[15.1%(220/1 449)与3.5%(106/2 974),P<0.05]及尿酸结石[10.7%(156/1 449)与8.4%(250/2 974),P<0.05]比例均明显高于浙北地区。结论浙江省泌尿系结石成分分布存在性别、年龄及地域差异。碳酸磷灰石及磷酸铵镁结石多见于女性患者,而尿酸结石多见于男性患者;随着年龄的增长,草酸钙、碳酸磷灰石及磷酸铵镁结石比例降低,而尿酸结石比例升高;浙北地区草酸钙结石较常见,而浙南地区碳酸磷灰石、磷酸�Objective To study the constituents of urinary stones in patients in Zhejiang, and analyze the composition difference between patients from northern Zhejiang province and southern Zhejiang province. Methods From October 2012 to October 2018, clinical data of 4 423 urinary stone patients treated in Sir Run Run Shaw Hospital, the Second Affiliated Hospital of Wenzhou Medical University, and Huzhou First People's Hospital was retrospectively analyzed. Infrared spectrum was used to analyze urinary calculi constituents. Among 4 423 patients, there were 3 041 males and 1 382 females, male to female ratio was 2.2∶1, and the mean age was (51.2±16.5) years. There were 2 974 northern Zhejiang patients and 1 449 southern Zhejiang patients. High incidence age group was 41- 60 years[48.2%(2 136/4 423)]. The distribution characteristics of urinary calculi constituents in different groups of sex, age, and region were analyzed. Results Among the 4 423 cases, the mixed urinary stones were dominant in the urinary calculus [73.1%(3 235/4 423)], in which, the most component was the calcium oxalate monohydrate+ calcium oxalate dehydrate+ carbonated apatite [36.2%(1 604/4 423)];among the pure stones, the most component was the calcium oxalate monohydrate[16.3%(719/4 423)]. Carbonated apatite stones [70.1%(970/1 382) vs. 61.0%(1 856/3 041), P<0.05]and magnesium ammonium phosphate stones [12.7%(176/1 382) vs. 4.9%(150/3 041), P<0.05]were both more prevalent in females than males, but uric acid stones[10.6%(325/3 041) vs. 5.8%(81/1 382), P<0.05] were more common in males than females. The proportions of calcium oxalate stones[90.6%(961/1 060) vs. 76.2%(935/1 227), P<0.05], carbonated apatite stones[77.6%(823/1 060) vs. 50.7%(623/1 227), P<0.05], and magnesium ammonium phosphate stones[9.1%(97/1 060) vs. 6.5%(80/1 227), P<0.05] of 0-40 years group were all higher than >60 years group, however, uric acid stones were more frequent in >60 years group [3.5%(38/1 060) vs. 17.0%(209/1 227), P<0.05]. The proportion of calcium oxalate stones i

关 键 词：尿路结石 成分分析 性别 年龄 地域 

分 类 号：R691.4[医药卫生—泌尿科学]