重庆地区单中心泌尿系结石成分分析及临床研究（附839例报告）

Single-center study of constituent of urinary calculi of urolithiasis in Chongqing（report of 839 cases）

摘要:

目的：研究重庆地区尿石病患者尿路结石的成分组成特点，为本地区尿石病防治提供一定临床依据。方法：用红外光谱法对839例尿石病患者的结石标本进行检测，结合患者临床资料进行分析。结果：55.30%的结石患者来自主城区，其余44.70%来自周边区县。在结石例数≥40的各区县中，所占比例最高的前三种结石均为一水草酸钙、碳酸磷灰石及二水草酸钙。全部结石包括混合性成分结石558例、单一成分结石281例，前者成分组成模式主要包括一水草酸钙+碳酸磷灰石，以及一水草酸钙+碳酸磷灰石+二水草酸钙，后者结石成分主要包括一水草酸钙和无水尿酸。在性别对比中，六水磷酸铵镁在女性中所占比例（14.81%）明显高于男性（4.61%）。在环境对比中，二水草酸钙及碳酸磷灰石在城镇患者中的百分比（分别为45.67%和61.67%）明显高于农村患者（分别为35.98%和51.88%）。在发病情况对比中，碳酸磷灰石在首发患者所占比例（56.46%）明显低于复发患者（65.35%）。在感染情况对比中，六水磷酸铵镁在合并感染者所占比例（12.33%）明显高于未合并感染者（5.27%）。在病程对比中，碳酸磷灰石在长病程者所占比例（63.61%）明显高于短病程者（56.18%）。41~60岁患者占年龄构成比例最高（55.54%），其次为31~40岁患者（14.30%）及61~70岁患者（17.28%）。结论：本院尿石病患者大部分来自城镇地区。各地区结石成分均以草酸钙（包含一水草酸钙及二水草酸钙）及碳酸磷灰石为主。混合性成分结石多于单一成分结石。男性患者多于女性患者，而六水磷酸铵镁多见于女性患者结石。城镇患者多于农村患者，二水草酸钙及碳酸磷灰石更多见于城镇患者。首次发病者多于复发者，碳酸磷灰石更多见于复发者。合并感染者少于未合并感染者，六水磷酸铵镁更多见于合并感染者。病程短者多于病程长者，碳酸磷灰石更多见于病程长者。患者年龄主要集中在30~70岁。

Abstract:

Objective：To analyze the characteristics of the chemical composition of urinary calculi in Chongqing and to provide clinical evidence for prevention and treatment of urolithiasis. Methods：Totally 839 samples of urolithiasis were collected and analyzed with infrared spectroscopy and the relevant clinical data were analyzed. Results：There were 55.30% patients from the urban and 44.70% from the rural. The main components of calculi in districts with number≥40 are calcium oxalate monohydrate，dahllite and calcium oxalate dihydrate. All the calculi included 558 cases of mixed components and 281 cases of single component；the composition mode of the former was “calcium oxalate monohydrate+dahllite”，whiel the composition mode of the latter was “calcium oxalate monohydrate+dahllite+calcium oxalate dihydrate. In gender comparison，the proportion of six ammonium magnesium phosphate in female（14.81%） was significantly higher than that of male（4.61%）. In the envi－ronmental comparison，the percentages of calcium oxalate dihy－drate and dahllite in urban patients（45.67% and 61.67%） were significantly higher than those in rural patients（35.98% and 51.88%）. In the comparison between first onset and re－crudesce，dahllite in the first onset patients（56.46%） was sig－nificantly lower than that of the recurrent patients（65.35%）. In the comparison of infection，the six ammonium magnesium phosphate in the infected group（12.33%） was significantly higher than that in the non infected group（5.27%）. In the comparison of duration，dahllite in patients with long duration（63.61%） was signifi－cantly higher than that of short duration（56.18%）. Patients aged 41 to 60 years old accounted for the highest proportion of age（55.54%），followed by 31 to 40 years old（14.30%） and 61 to 70 years old（17.28%）. Conclusion：Urinary calculi in our hospital are mainly composed of mixed components，the main components of which are calcium oxalate（including calcium oxalate monohydrate and calcium oxalate dihydrate） and dahllite. Calculi with mixed components are more common than single component stones. Male patients are more than female patients，while six ammonium magnesium phosphate was more common in female patients. Urban pa－tients are more than rural patients，and calcium oxalate dihydrate as well as dahllite are more common in urban patients. Patients with the first onset was more frequent than recurrent patients，and dahllite is more common in recurrent patients. The infected patients is fewer than the non infected patients，and the six ammonium magnesium phosphate is more common in the patients with infection. Patients with short duration is more than who with long duration，and dahllite is more common in the patients with long duration. The age of patients is mainly concentrated in 30 to 70 years old.