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墨西哥东南部尿石症患者尿路结石的计算机断层扫描特征

Computed tomographic characterization of urinary stones in patients with urolithiasis from Southeast Mexico.

作者信息

Sánchez-Pozos Katy, Ramírez-Jurado Abraham Adolfo, Medina-Escobedo Martha, Garrido-Dzib Ángel Gabriel, González-Rocha Lizeth Araceli, Gutiérrez-Solis Ana Ligia, Avila-Nava Azalia, Lugo Roberto

机构信息

Research Division, Hospital Juarez de Mexico, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Delegación Gustavo A. Madero, 07760. Ciudad de Mexico, Mexico.

Department of Radiology, Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Calle 7 por 20 y 22 Num 433, Fracc. Altabrisa, 97130, Merida, Mexico.

出版信息

Heliyon. 2023 Dec 10;10(1):e23547. doi: 10.1016/j.heliyon.2023.e23547. eCollection 2024 Jan 15.

Abstract

Urolithiasis (UL) is a severe public health concern in southeastern Mexico. Computed tomography (CT) is the first-line diagnostic method for patients with suspected UL. The present study aimed to characterize stones in the entire urinary system using CT and to contribute to personalized treatment in patients with UL. Patients >18 years of age with suspected UL were enrolled. Characteristics of UL included stone size, location (kidney, ureters, and bladder), composition of the stone in Hounsfield units (HU), presence of staghorn stone(s), and obstructive uropathy. Patients were stratified according to sex and age to determine whether stone size and HU were dependent on hormonal factors in females and on prostatic hyperplasia in males. The Mann-Whitney test was used to compare median values. Frequencies are expressed as percentages and were analyzed using the Mantel-Haenszel chi-squared test. A total of 1150 patients were included in this study, of whom 744 (64.7 %) had UL in only 1 anatomical location in the urinary system, and 406 (35.3 %) had stones in ≥2 anatomical locations. Localization and stone size differed between males and females (p < 0.05). Additionally, males exhibited differences in HU (p = 0.024) and frequency of obstructive uropathy (p = 0.10) when stratified according to age (≤50 and > 50 years). In addition, females exhibited statistical differences in HU (p = 0.010) and kidney stone size (p = 0.047) dependent on age (≤47 and > 47 years). In conclusion, findings suggest that HU and stone size differ in different anatomical structures of the urinary system. In addition, differences in stone size and composition may be associated with age and sex.

摘要

尿石症(UL)是墨西哥东南部一个严重的公共卫生问题。计算机断层扫描(CT)是疑似UL患者的一线诊断方法。本研究旨在利用CT对整个泌尿系统的结石进行特征描述,并为UL患者的个性化治疗提供帮助。纳入年龄大于18岁的疑似UL患者。UL的特征包括结石大小、位置(肾脏、输尿管和膀胱)、以亨氏单位(HU)表示的结石成分、鹿角形结石的存在以及梗阻性尿路病。根据性别和年龄对患者进行分层,以确定结石大小和HU是否取决于女性的激素因素和男性的前列腺增生。采用曼-惠特尼检验比较中位数。频率以百分比表示,并使用曼德尔-亨泽尔卡方检验进行分析。本研究共纳入1150例患者,其中744例(64.7%)仅在泌尿系统的1个解剖位置有UL,406例(35.3%)在≥2个解剖位置有结石。男性和女性的结石定位和大小存在差异(p<0.05)。此外,根据年龄(≤50岁和>50岁)分层时,男性在HU(p=0.024)和梗阻性尿路病频率(p=0.10)方面存在差异。此外,女性在HU(p=0.010)和肾结石大小(p=0.047)方面存在统计学差异,这取决于年龄(≤47岁和>47岁)。总之,研究结果表明,HU和结石大小在泌尿系统的不同解剖结构中存在差异。此外,结石大小和成分的差异可能与年龄和性别有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b70c/10758874/012d48b8297d/gr1.jpg

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