新疆地区婴幼儿泌尿系结石的结石成分及临床特征分析  

Analysis of stone composition and clinical characteristics of urinary calculi in infants in Xinjiang

作　　者：贾宏亮[1] 杜伟丽[1] 南玉奎[1] 艾尼瓦尔·玉素甫 刘东 叶尔番·艾尔肯 张培新[1] 摆凤兰[1] 雷鹏[1] 李九智[1] Jia Hongliang;Du Weili;Nan Yukui;Ainiwaer·Yusufu;Liu Dong;Yeerfan·Aierken;Zhang Peixin;Bai Fenglan;Lei Peng;Li Jiuzhi(Urological Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Department of Urology,Children's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830054,China)

机构地区：[1]新疆维吾尔自治区人民医院泌尿中心,乌鲁木齐830001 [2]新疆维吾尔自治区儿童医院泌尿外科,乌鲁木齐830054

出　　处：《国际外科学杂志》2023年第6期407-412,共6页International Journal of Surgery

基　　金：新疆维吾尔自治区自然科学基金项目(2021D01C165)。

摘　　要：目的分析新疆地区婴幼儿泌尿系结石的结石成分及临床特征。方法回顾性分析2016年1月—2021年12月新疆维吾尔自治区人民医院收治的75例泌尿系结石婴幼儿的临床资料,包括患儿的一般情况、结石相关参数、随机尿pH值、尿培养、实验室检查结果,并比较尿酸铵结石与非尿酸铵结石婴幼儿的血尿酸、血钙、尿pH值、尿培养阳性率、结石长径。符合正态分布的计量资料以均数±标准差(x±s)表示,组间比较采用独立样本t检验;不符合正态分布的计量资料以中位数(四分位间距)[M(Q_(1),Q_(3))]表示,组间比较采用Mann-Whitney U检验。计数资料组间比较采用χ^(2)检验、连续性校正χ^(2)检验或Fisher确切概率法。结果泌尿系结石婴幼儿的中位年龄为23.04个月,男女比例为3.2:1。半数以上(81.3%,61/75)患儿来自农村,57.3%(43/75)患儿营养不良,33.3%(25/75)患儿合并尿路感染,8.0%(6/75)患儿合并泌尿系先天性畸形。结石部位为肾脏53例(70.67%),输尿管27例(36.00%),尿道17例(22.67%),膀胱16例(21.33%)。结石成分分析提示,尿酸铵44例(58.67%),草酸钙39例(52.0%),碳酸磷灰石14例(18.67%),尿酸7例(9.33%)。女性婴幼儿肾结石更为常见(P=0.011)。婴儿组(n=19)与幼儿组(n=56)相比,幼儿组草酸钙结石更为常见(P=0.039),而尿酸铵、碳酸磷灰石、尿酸结石的发生率差异并无统计学意义。尿酸铵组与非尿酸铵组相比,性别、年龄、居住地、营养状况、血尿酸、血钙、尿pH值、尿培养阳性率、结石最大径、膀胱结石发生率差异均无统计学意义。结论婴幼儿泌尿系结石男性的发病率较高,最常见的结石部位是上尿路,女性肾结石更常见。尿酸铵是婴幼儿泌尿系结石的主要成分。与婴儿组相比,幼儿组草酸钙结石更为常见。婴幼儿泌尿系结石患儿多为农村居民,营养不良与尿路感染较为常见。Objective To analyze the composition and clinical characteristics of urinary calculi in infants in Xinjiang.Methods The clinical data of 75 infants with urinary calculi admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2021 were retrospectively analyzed,including the general situation of the children,stone-related parameters,random urine pH value,urine culture and biochemical examination results.The serum uric acid,serum calcium,urine pH value,positive rate of urine culture,and stone length between infants with and without ammonium urate stones were compared.Measurement data conforming to normal distribution were expressed as mean±standard deviation(x±s),and independent sample t-test was used for inter-group comparison.Measurement data that did not conform to the normal distribution were expressed as the median(interquartile distance)[M(Q_(1),Q_(3))],and Mann-Whitney U test was used for comparison between groups.The Chi-square test,continuity-corrected Chi-square test or Fisher exact probability method were used for the comparison of count data.Results The median age of infants with urinary calculi was 23.04 months,and the ratio of male to female was 3.2∶1.More than half of the infants(81.3%,61/75)came from rural areas,57.3%(43/75)were malnourished,33.3%(25/75)were complicated with urinary tract infection,and 8.0%(6/75)were combined with urinary system congenital malformation.The calculi were found in 53 cases(70.67%)of kidney,27 cases(36.0%)of ureter,17 cases(22.67%)of urethra and 16 cases(21.33%)of bladder.The analysis of calculi composition showed that there were 44 cases(58.67%)of ammonium urate,39 cases(52.0%)of calcium oxalate,14 cases(18.67%)of apatite carbonate and 7 cases(9.33%)of uric acid.Kidney calculi was more common in female infants(P=0.011).Compared with the infant group(n=19),calcium oxalate stones were more common in the preschooler group(n=56)(P=0.039),but there were not statistical difference in the incidence of ammonium urate,apatite carbo

关 键 词：结石 泌尿系疾病 疾病特征 婴幼儿 结石成分分析 

分 类 号：R726.9[医药卫生—儿科]