Rouprêt Morgan, Daudon Michel, Hupertan Vincent, Gattegno Bernard, Thibault Philippe, Traxer Olivier
Department of Urology, Tenon Hospital, AP-HP, Paris, France.
Urology. 2005 Aug;66(2):246-51. doi: 10.1016/j.urology.2005.03.054.
To determine the value of mid-infrared spectroscopy (MIRS) of ureteral stent encrustations in predicting urinary stone composition.
A retrospective study analyzed the composition of stent encrustations and urinary stones by MIRS in patients who had had a stent for ureteral obstruction between 2001 and 2003. The overall correlation was evaluated. The correlation coefficient kappa for agreement between the proportions of each component was calculated.
A total of 72 stents and 72 stones from 72 patients were analyzed. The mean stent indwelling time was 55.5 days (range 14 to 102). The stents had been placed for fever (52 cases, 72%), pain refractory to analgesics (15 cases, 21%), and impairment of kidney function (5 cases, 7%). The overall correlation between stone composition and stent encrustation was 71.4%, excluding biofilm analysis. The kappa value was 0.78 for the main component (n = 72; P < 0.0005), 0.61 for the secondary component (n = 72; P < 0.0005), and 0.91 for the agreement between the composition of encrustations at each end of a stent (n = 30; P < 0.0005).
MIRS analysis of stent encrustations is a reliable method of predicting stone composition when the stone cannot be retrieved. Systematic MIRS analysis of stent encrustations is not recommended but can be very useful in clinical situations in which no stone is available.
确定输尿管支架结壳的中红外光谱（MIRS）在预测尿结石成分方面的价值。
一项回顾性研究分析了2001年至2003年间因输尿管梗阻置入支架的患者中，通过MIRS对支架结壳和尿结石成分进行的分析。评估了总体相关性。计算了各成分比例之间一致性的相关系数kappa。
共分析了72例患者的72个支架和72块结石。支架平均留置时间为55.5天（范围14至102天）。置入支架的原因有发热（52例，72%）、止痛药难以缓解的疼痛（15例，21%）和肾功能损害（5例，7%）。排除生物膜分析后，结石成分与支架结壳之间的总体相关性为71.4%。主要成分的kappa值为0.78（n = 72；P < 0.0005），次要成分的kappa值为0.61（n = 72；P < 0.0005），支架两端结壳成分之间一致性的kappa值为0.91（n = 30；P < 0.0005）。
当无法获取结石时，对支架结壳进行MIRS分析是预测结石成分的可靠方法。不建议对支架结壳进行系统性MIRS分析，但在没有结石的临床情况下可能非常有用。
