活度积比和EQUIL2法评估中国肾结石患者常见钙盐成分尿液相对过饱和水平的一致性分析  

Consistency evaluation of activity product ratio and EQUIL2 program in estimating urinary relative supersaturation of common calcium salts in patients with kidney stones in China

作　　者：周悦玲 李允武[2] 朱秋毓 丁峰[1] 王文姬[1] ZHOU Yueling;LI Yunwu;ZHU Qiuyu;DING Feng;WANG Wenji(Department of Nephrology,Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of Pharmacy,Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院肾脏内科,上海200011 [2]上海交通大学医学院附属第九人民医院药剂科,上海200011

出　　处：《临床检验杂志》2022年第1期1-7,共7页Chinese Journal of Clinical Laboratory Science

基　　金：上海交通大学医学院附属第九人民医院临床研究型多学科诊疗团队项目(201701019)。

摘　　要：目的探究活度积比和EQUIL2法在评估我国肾结石患者尿液草酸钙和磷酸钙等常见钙盐成分相对过饱和水平的一致性。方法回顾性分析2015年9月—2020年9月于上海交通大学医学院附属第九人民医院就诊的肾结石患者的临床资料,收集24 h尿液成分分析结果,利用活度积比和EQUIL2法分别计算尿液草酸钙和磷酸钙(包括透钙磷石和羟磷灰石)相对过饱和水平各项指标。采用相关性分析、线性回归分析和BlandAltman一致性检验比较活度积比和EQUIL22种方法评估尿液草酸钙和磷酸钙相对过饱和水平的相关性和一致性。结果该研究共纳入99例肾结石患者,其中男性53例,女性46例。活度积比和EQUIL2法计算尿液草酸钙(r=0.930,95%CI:0.896~0.953,P<0.001)、透钙磷石(r=0.979,95%CI:0.969~0.986,P<0.001)和羟磷灰石(r=-0.968,95%CI:-0.979~-0.952,P<0.001)相对过饱和水平所得结果均具有较强相关性,线性回归分析显示2种方法在评估尿液草酸钙相对过饱和水平(调整后R^(2)=0.904,P<0.001)和羟磷灰石相对过饱和水平(调整后R^(2)=0.936,P<0.001)的模型拟合程度较高,而在透钙磷石相对过饱和水平的评估上模型拟合程度一般(调整后R^(2)=0.749,P<0.001)。BlandAltman一致性检验显示2种方法所得结果的差值主要分布于95%一致性界限内,表明活度积比和EQUIL2法在评估尿液草酸钙和磷酸钙相对过饱和水平上均具有较高的一致性。结论活度积比和EQUIL2法在评估我国肾结石患者尿液草酸钙和磷酸钙等常见钙盐成分相对过饱和水平上具有较高的一致性。Objective To explore the consistency of two methods,activity product ratio and EQUIL2 program,in estimating urinary supersaturation of common calcium salts,e.g.,calcium oxalate and calcium phosphate,in patients with kidney stones in China.Methods The medical records of patients with kidney stones in Shanghai Ninth People′s Hospital affiliated to Shanghai Jiao Tong University School of Medicine during September 2015 to September 2020 were analyzed retrospectively.The clinical data of 24 hours urine analysis were collected,and urinary relative supersaturation of calcium oxalate and calcium phosphate(including brushite and hydroxyapatite)were calculated simultaneously by both of activity product ratio and EQUIL2 program.The correlation and consistency between the two methods were explored by analysis of correlation,linear regression and BlandAltman agreement to estimate the urinary supersaturation of calcium oxalate and calcium phosphate.Results A total of 99 patients(53 males and 46 females)with kidney stones were included in the study.The results of activity product ratio and EQUIL2 program showed good correlation in estimating urinary relative supersaturation of calcium oxalate(r=0.930,95%CI:0.896 to 0.953,P<0.001),brushite(r=0.979,95%CI:0.969 to 0.986,P<0.001)and hydroxyapatite(r=-0.968,95%CI:-0.979 to-0.952,P<0.001).The regression models in estimating urinary relative supersaturation of calcium oxalate(adjusted R^(2)=0.904,P<0.001)and hydroxyapatite(adjusted R^(2)=0.936,P<0.001)showed high fitting degrees,but moderate fitting degrees for brushite(adjusted R^(2)=0.749,P<0.001).BlandAltman agreement analysis showed the difference value of the results of activity product ratio and EQUIL2 program mainly distributed between the 95%limits of agreement,indicating good consistency of both the methods in estimating urinary supersaturation of calcium oxalate and calcium phosphate.Conclusion Both the methods of activity product ratio and EQUIL2 program have good consistency in estimating urinary

关 键 词：肾结石 尿液相对过饱和水平 钙盐 活度积比 EQUIL2 

分 类 号：R446[医药卫生—诊断学] R692.4[医药卫生—临床医学]