Imran Kiran, Zafar Mirza Naqi, Fatima Naureen, Ozair Uzma, Sultan Sajid, Hasan Rizvi Syed Adibul
Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
J Ayub Med Coll Abbottabad. 2017 Oct-Dec;29(4):630-634.
Chemical composition of stones is one of the important diagnostic criteria for aetiology of stone formation and treatment to prevent recurrence. This paper reports composition of stones in children at a tertiary hospital by Fourier Transformation Infrared Spectroscopy (FTIR).
Between January-June 2015, 412 urinary stones from children were analysed by FTIR. Chi-square tests were used for the comparison of categorical measurements between groups. All reported values were 2-sided and statistical significance was considered at p-value ≤0.05.
Of the 412 stones, 263 (63.8%) were renal, 101(24.5%) bladder and 48 (11.7%) ureteric. The mean age of children was 7.15±4.13 years with a M:F ratio 2.4:1. Of the 412 stones, 144(34.9%) were pure stones composed of one compound and 268(65.1%) were mixtures. Frequency of compound in stones was Ammonium Acid Urate (AAU) (65%), Calcium Oxalate (CaOx) (76.9%), Uric Acid (5%), Calcium Phosphate Apatite (7%), Whitlockite (8.4%), Struvite (4%), Cystine (0.72%) and Xanthine (2.11%). Frequency of compounds analysed in three ages groups 0-5, 6-10 and 11-15 years showed high frequency of AAU (73%) in 0-5 years as compared to (60%) in 11-15 years (p<0.018). CaOx (90%) in 11-15 as compared to (62.5%) in 0-5 years (p<0.001). Bladder stones were more prevalent in children 0-5 years (32%) vs 19% in 11-15 years (p<0.004) while renal were 75% in 11-15 years and 54% in 0-5 years (p<0.04).
AAU stones known to be associated with malnutrition and chronic diarrhoea are highly prevalent in paediatric stones formers in our population in the kidney, bladder and ureter.
结石的化学成分是结石形成病因诊断及预防复发治疗的重要标准之一。本文通过傅里叶变换红外光谱法（FTIR）报告一家三级医院儿童结石的成分。
2015年1月至6月期间，对412例儿童尿结石采用FTIR进行分析。采用卡方检验比较组间分类测量值。所有报告值均为双侧，p值≤0.05时认为具有统计学意义。
412颗结石中，263颗（63.8%）为肾结石，101颗（24.5%）为膀胱结石，48颗（11.7%）为输尿管结石。儿童的平均年龄为7.15±4.13岁，男女性别比为2.4:1。412颗结石中，144颗（34.9%）为单一化合物组成的纯结石，268颗（65.1%）为混合结石。结石中化合物的出现频率依次为尿酸铵（AAU）（65%）、草酸钙（CaOx）（76.9%）、尿酸（5%）、磷酸钙磷灰石（7%）、白磷钙矿（8.4%）、鸟粪石（4%）、胱氨酸（0.72%）和黄嘌呤（2.11%）。在0至5岁、6至10岁和11至15岁三个年龄组中分析的化合物频率显示，0至5岁组中AAU的频率较高（73%），而11至15岁组中为（60%）（p<0.018）。11至15岁组中CaOx的频率为（90%），而0至5岁组中为（62.5%）（p<0.001）。膀胱结石在0至5岁儿童中更为常见（32%），而在11至15岁儿童中为19%（p<0.004），而肾结石在11至15岁儿童中占75%，在0至5岁儿童中占54%（p<0.04）。
已知与营养不良和慢性腹泻相关的AAU结石在我们人群中的儿童肾结石、膀胱结石和输尿管结石患者中高度普遍。
