河北省唐山地区尿路结石成分红外光谱分析

高双友宋蕊李双利温英武王美美

(开滦总医院泌尿外科河北唐山063000)

[摘要]①目的分析河北省唐山地区尿路结石的组成成分，为本地区临床尿路结石的治疗及预防提供参考。②方法收集我院门诊体外冲击波碎石和住院患者手术取石的结石标本393例进行红外光谱分析。③结果上尿路结石明显多于下尿路结石，上下尿路结石之比为17.7:1。输尿管结石占尿路结石首位，为63.10%(248/393)。84.99%(334/393)的结石含有草酸钙。单一成分结石占37.15%(146/393)，混合成分结石占62.85%(247/393)，差异有统计学意义(χ2=3.91，P<0.05)。单一成分结石中以一水草酸钙为主，占59.59%(87/146)，其次为无水尿酸，占24.66%(36/146)；无水尿酸男性与女性比较差异有统计学意义(χ2=0.46，P<0.05)，其余成分男性与女性比较差异无统计学意义(P>0.05)。混合成分结石中以一水草酸钙+二水草酸钙+碳酸磷灰石为主，占41.30%(102/247)，混合各成分结石中男性与女性比较差异无统计学意义(P>0.05)。④结论尿路结石分析对于了解本地区结石的成因，预防结石形成和复发具有重要的临床意义。

[关键词]尿路结石结石分析红外光谱

[中图分类号]R 691.4[文献标识码]A

【作者简介】高双友(1974-)，男，副主任医师，硕士。研究方向：泌尿外科。

Analysis of urinary calculi composition in Tangshan district of HebeiGAOShuangyou,SONGRui,LIShuangli,etal(DepartmentofSurgicalUrology,KailuanCoalGeneralHospital,TangShan063000,China)

ABSTRACT[]ObjectiveTo provide reference for clinical treatment and prevention of urinary calculi,using Infrared spectroscopy to analyze the urinary calculi composition in Tang Shan District of He Bei Province.MethodsKai Luan Coal General Hospital, after extra-corporeal shock wave lithotripsy patient discharge and inpatient surgery for removal of 393 cases of urinary calculi sam-ples using Infrared spectroscopy for anaiysis.ResultsThe upper urinary tract stones were more frequently found than the lower urinary tract stones,and the ratio was 17.7:1.The rate of ureteral calculi was highest in all the urinary calculi 63.10%(248/393);The detection rate of calcium oxalate was highest in all the chemical components,accounting for 84.99%(334/393).The single component calculus accounts for 37.15%(146/393),The Mixed composition of stones account for 62.85%(247/393),There was significant difference (χ2=0.46，P<0.05).The most common type was Calcium oxalate monohydrate in the single component calculus, accounting for 59.59%(87/146),Secondiy,anhydrous uric acid account for 24.66%(36/146),There was significant difference in the anhydrous uric acid calculi between males and females(χ2=0.46，P<0.05),The rest of the single component calculus were no significant difference between males and females(P>0.05). The most common type was Calcium oxalate monohydrate+Calcium oxalate dehydrate+Carbonate apatite in the Mixed composition of stones, accounting for41.30%(102/247), All the Mixed composition of stones were no significant difference between males and females(P>0.05).ConclusionIt is significant to analyze the urinary calculi composition for investigating the cause of stones ,preventing stone formation and recurrence.

[KEYWORDS]Urinary calculi l.Analysis of urinary stone.Infrared spectroscopy

尿路结石是泌尿系统常见病和多发病，微创治疗方法多、疗效确切， 但治疗后未经预防的患者5年的复发率高达50%，而接受防治的患者复发率可降至15%及以下[1]。该病病因复杂，地域差异和个体差异较大，因此确定结石的成分及性质对疾病的治疗和预防具有重要的临床意义。笔者对唐山地区393例患者的结石标本通过红外光谱法测定尿路结石成分，为本地区临床防治提供帮助，报告如下。

1资料与方法

1.1一般资料收集我院2010年5月～2014年5月门诊体外冲击波碎石和住院患者手术取石的结石标本393例进行红外光谱分析，其中男237例，女156例，年龄5～85岁，平均(52.5±11.6)岁。上尿……