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中国尿路结石成分的现状和特征。

The status and characteristics of urinary stone composition in China.

机构信息

Department of Urology, Tongji Medical School, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.

Hubei Institute of Urology, Wuhan, China.

出版信息

BJU Int. 2020 Jun;125(6):801-809. doi: 10.1111/bju.14765. Epub 2020 Apr 6.

Abstract

OBJECTIVES

To explore characteristics of urinary stone composition in China, and determine the effects of gender, age, body mass index (BMI), stone location, and geographical region on stone composition.

PATIENTS AND METHODS

We prospectively used Fourier-transform infrared spectroscopy to analyse stones from consecutive patients presenting with new-onset urolithiasis at 46 hospitals in seven geographical areas of China, between 1 June 2010 and 31 May 2015. Chi-squared tests and logistic regression analyses were used to determine associations between stone composition and gender, age, BMI, stone location, and geographical region.

RESULTS

The most common stone constituents were: calcium oxalate (CaOx; 65.9%), carbapatite (15.6%), urate (12.4%), struvite (2.7%), and brushite (1.7%). CaOx and urate stones occurred more frequently in males, whereas carbapatite and struvite were more common in females (P < 0.01). CaOx and carbapatite were more common in those aged 30-50 and 20-40 years than in other groups. Brushite and struvite were most common amongst those aged <20 and >70 years. The detection rate of urate increased with age, whilst cystine decreased with age. Obese patients were more likely to have urate stones than carbapatite or brushite stones (P < 0.01). CaOx, carbapatite, brushite, and cystine stones were more frequently found in the kidney than other types, whereas urate and struvite were more frequent in the bladder (P < 0.01). Stone composition varied by geographical region.

CONCLUSIONS

The most common stone composition was CaOx, followed by carbapatite, urate, struvite, and brushite. Stone composition differed significantly in patients grouped by gender, age, BMI, stone location, and geographical region.

摘要

目的

探讨中国尿路结石成分的特点,并确定性别、年龄、体重指数(BMI)、结石部位和地理区域对结石成分的影响。

方法

我们前瞻性地使用傅里叶变换红外光谱法分析了 2010 年 6 月 1 日至 2015 年 5 月 31 日期间,来自中国 7 个地理区域的 46 家医院新诊断为尿石症的连续患者的结石。卡方检验和 logistic 回归分析用于确定结石成分与性别、年龄、BMI、结石部位和地理区域之间的关系。

结果

最常见的结石成分是:草酸钙(CaOx;65.9%)、碳磷灰石(15.6%)、尿酸(12.4%)、磷酸铵镁(struvite;2.7%)和二水草酸钙(brushite;1.7%)。CaOx 和尿酸结石在男性中更为常见,而碳磷灰石和 struvite 在女性中更为常见(P<0.01)。30-50 岁和 20-40 岁的患者中 CaOx 和碳磷灰石更为常见。20 岁以下和 70 岁以上的患者中,最常见的是 brushite 和 struvite。尿酸的检出率随年龄增长而增加,而胱氨酸则随年龄增长而减少。肥胖患者比碳磷灰石或 brushite 结石更易患尿酸结石(P<0.01)。CaOx、碳磷灰石、brushite 和胱氨酸结石在肾脏中比其他类型更为常见,而尿酸和 struvite 结石在膀胱中更为常见(P<0.01)。结石成分因地理区域而异。

结论

最常见的结石成分是 CaOx,其次是碳磷灰石、尿酸、struvite 和 brushite。性别、年龄、BMI、结石部位和地理区域不同的患者的结石成分有显著差异。

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