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作 者:沈新宇 黄玉华[1] 尤佳楠 苏赛 袁和兴[1] 陈长 陈创 丁翔[1] SHEN Xinyu;HUANG Yuhua;YOU Jia’nan;SU Sai;YUAN Hexing;CHEN Zhang;CHEN Chuang;DING Xiang(Department of Urology,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)
机构地区:[1]苏州大学附属第一医院泌尿外科,江苏苏州215006
出 处:《临床泌尿外科杂志》2022年第11期861-865,共5页Journal of Clinical Urology
基 金:苏州市科技计划项目(No:SYS2018044)。
摘 要:目的:探讨24 h尿液代谢评估联合肾功能指标在上尿路尿酸结石诊断中的价值。方法:回顾性分析2019年2月—2022年1月我院495例上尿路结石患者的临床资料,根据术后结石成分分析结果分为尿酸结石组(43例)与非尿酸结石组(452例),比较两组间的临床指标差异。应用ROC曲线确定不同指标的最佳截断值并进行分组,通过单因素及多因素logistic回归分析上尿路尿酸结石形成的独立危险因素。结果:尿酸结石组与非尿酸结石组年龄、血尿素、肌酐、尿酸、尿pH、24 h尿枸橼酸、24 h尿钙以及BMI≥25 kg/m^(2)、高血压、高血糖、高血脂比例均差异有统计学意义(均P<0.05)。logistic回归分析结果显示,年龄≥49.5岁(OR=2.767,95%CI:1.026~7.463)、高血糖(OR=3.362,95%CI:1.216~8.750)、血肌酐≥92.4μmol/L(OR=3.462,95%CI:1.366~8.776)、血尿酸≥443.6μmol/L(OR=2.564,95%CI:1.093~6.018)、尿pH≤5.7(OR=7.586,95%CI:3.158~18.226)、尿钙≤3.15 mmol/24 h(OR=3.753,95%CI:1.439~9.787)是上尿路尿酸结石的独立危险因素。结论:年龄、高血糖、血肌酐、血尿酸、尿pH及24 h尿钙是上尿路尿酸结石形成的危险因素,可作为上尿路尿酸结石诊疗的临床依据。Objective:To explore the value of 24 h urine metabolic assessment combined with renal function indexes in the diagnosis of uric acid stones in the upper urinary tract.Methods:The clinical data of 495 patients with upper urinary tract stones in our hospital from February 2019 to January 2022 were retrospectively analyzed.According to the results of stone composition analysis after surgery,they were divided into uric acid stone group(n=43)and non uric acid stone group(n=452),the differences of clinical indexes between the two groups were compared.Receiver operating characteristic(ROC)curve was performed on these indexes to obtain the cut-off value and the patients were grouped according to it.The independent risk factors of upper urinary tract uric acid stone were analyzed by univariate and multivariate logistic regression.Results:The differences in age,blood urea,serum creatinine,blood uric acid,urine pH,24 h urinary citrate,24 h urinary calcium,BMI≥25 kg/m^(2),hypertension,hyperglycemia and hyperlipidemia between the two groups were statistically significant(all P<0.05).Logistic regression analysis showed that age≥49.5 years old(OR=2.767,95%CI:1.026-7.463),hyperglycemia(OR=3.362,95%CI:1.216-8.750),serum creatinine≥92.4μmol/L(OR=3.462,95%CI:1.366-8.776),blood uric acid≥443.6μmol/L(OR=2.564,95%CI:1.093-6.018),urine pH≤5.7(OR=7.586,95%CI:3.158-18.226),and urinary calcium≤3.15 mmol/24 h(OR=3.753,95%CI:1.439-9.787)were independent risk factors of upper urinary tract uric acid stones.Conclusion:Age,hyperglycemia,serum creatinine,blood uric acid,urinary pH,and 24 h urinary calcium are risk factors for the formation of upper urinary tract uric acid stones,and they can be used as clinical basis for the diagnosis and treatment of it.
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