Meiouet F, El Kabbaj S, Daudon M
Laboratoire de recherches et d'analyses médicales de la gendarmerie royale, avenue Ibn Sina, Agdal, Rabat, Morocco.
Laboratoire des Lithiases, service des explorations fonctionnelles, hôpital Tenon, AP-HP, 4, rue de la Chine, 75970 Paris, France.
Prog Urol. 2019 Mar;29(3):173-182. doi: 10.1016/j.purol.2019.02.002. Epub 2019 Feb 25.
Incidence of pediatric urolithiasis is decreasing in most developing countries where endemic bladder stones are less prevalent than in the past years. In parallel, stone composition has changed. Only few data are available in North Africa, except for Tunisia. We report stone composition in the Moroccan pediatric population.
Composition of 432 stones from children (302 boys, 130 girls) was determined by infrared spectroscopy. The samples were collected during the period 1999-2016. Stone morphology, which is an important aspect for etiology was determined by examination of each stone under a stereomicroscope. Stone composition was compared to patients' age and gender.
The global male-to-female ratio was 2.32. Regarding stone composition, calcium oxalate was the main component in 51.6% of the stones, followed by struvite (18.1%), ammonium urate (9.5%) and carbapatite (9%). Significant differences were found between males and females: calcium oxalate accounted for 72.3% of stones in girls and 42.7% in boys (P<10); conversely, struvite was more frequent in boys than in girls (22.2 vs 8.5%, P<10). The same was found for calcium phosphate stones (11.9% in boys; 4.6% in girls, P<0.05). Stone morphology helped us for detecting several pathological conditions: type Ic whewellite stones, as a marker for primary hyperoxaluria, was found in 17.6% of stones and type IIId ammonium urate stones, suggestive for infectious diarrhea, was identified in 20.1% of all stones.
This is the largest series of pediatric stones in Morocco studied by infrared analysis and morphological examination.
在大多数发展中国家，小儿尿石症的发病率正在下降，这些国家地方性膀胱结石的发病率低于过去几年。与此同时，结石成分也发生了变化。除突尼斯外，北非只有很少的数据。我们报告了摩洛哥小儿人群的结石成分。
采用红外光谱法测定了432例儿童（302例男孩，130例女孩）结石的成分。样本采集于1999年至2016年期间。结石形态是病因学的一个重要方面，通过在体视显微镜下检查每块结石来确定。将结石成分与患者的年龄和性别进行比较。
总体男女比例为2.32。关于结石成分，草酸钙是51.6%的结石的主要成分，其次是磷酸镁铵（18.1%）、尿酸铵（9.5%）和碳酸磷灰石（9%）。男性和女性之间存在显著差异：草酸钙在女孩结石中占72.3%，在男孩结石中占42.7%（P<0.01）；相反，磷酸镁铵结石在男孩中比在女孩中更常见（22.2%对8.5%，P<0.01）。磷酸钙结石也是如此（男孩中为11.9%；女孩中为4.6%，P<0.05）。结石形态有助于我们检测几种病理情况：Ic型水草酸钙结石作为原发性高草酸尿症的标志物，在17.6%的结石中发现，IIId型尿酸铵结石提示感染性腹泻，在所有结石的20.1%中发现。
这是摩洛哥通过红外分析和形态学检查研究的最大系列小儿结石。
3级。
