| 摘要: |
| 目的 评估肾结石患者的人口学分布和临床合并症特点并探索其相关因素，为临床防治提供依据。方法 回顾性分析2017年1月至2020年12月海军军医大学（第二军医大学）第一附属医院门诊及住院患者中影像学报告为肾结石的10 140例患者资料。根据肾脏受累情况，分为单侧肾结石组（单侧组）及双侧肾结石组（双侧组），比较两组患者在年龄、性别、实验室检查指标、常见临床合并症上的差异，采用logistic回归分析探寻可能影响双侧肾结石形成的相关因素。结果 10 140例肾结石患者的年龄为（57.75±13.30）岁，其中≤30岁276例（2.7%），31～64岁6 647例（65.6%），≥65岁3 217例（31.7%）；男7 021例（69.3%），女3 119例（30.7%），男女比例为2.25∶1。所有肾结石患者最常见的临床合并症依次为高血压病（3 285例，32.4%）、肿瘤（2 775例，27.4%）、高尿酸血症（2 007例，19.8%）、糖尿病（1 526例，15.0%）、冠心病（1 072例，10.6%）、脑血管疾病（473例，4.7%）。单侧组8 171例（80.6%），双侧组1 969例（19.4%）。双侧组年龄低于单侧组，男性占比高于单侧组，血清肌酐、尿酸、尿pH值水平高于单侧组，高密度脂蛋白胆固醇水平低于单侧组，合并高血压病、高尿酸血症的患者占比高于单侧组，合并肿瘤、冠心病的患者占比低于单侧组，差异均有统计学意义（P均<0.05）；两组患者BMI、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平及合并糖尿病、脑血管疾病的患者比例差异均无统计学意义（P均>0.05）。logistic回归分析结果显示，性别（男性）、高尿酸血症可能是双侧肾结石形成的重要危险因素，而合并肿瘤则更多见于单侧肾结石患者（P均<0.05）。结论 肾结石更多见于中年男性，代谢综合征相关疾病在肾结石的发展过程中起着重要作用，有必要加强这些疾病的早期防治。肾结石患者肿瘤合并率高，提示两者存在关联。此外，较单侧肾结石而言，男性、合并高尿酸血症与双侧肾结石形成关系更为密切，应当引起重视。 |
| 关键词: 肾结石 临床合并症 高尿酸血症 肿瘤 代谢综合征 |
| DOI：10.16781/j.CN31-2187/R.20220420 |
| 投稿时间：2022-05-18修订日期：2022-11-14 |
| 基金项目:国家自然科学基金（81300613）. |
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| Clinical comorbidities and related factors of kidney stones: an analysis of 10 140 patients |
| LI He-wen1,2,ZHOU Wen-yu-jing3,WANG Li-peng4,GUO Zhi-yong1,DONG Rui1* |
(1. Department of Nephrology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Department of Heart and Nephrology, The 942nd Hospital of PLA, Yinchuan 750001, Ningxia Hui Autonomous Region, China;
3. Department of Hematology, Chengdu First People's Hospital, Chengdu 610095, Sichuan, China;
4. Information Department, Shanghai Fourth People's Hospital Affiliated to Tongji University, Shanghai 200081, China
*Corresponding authors) |
| Abstract: |
| Objective To evaluate the demographic distribution and clinical comorbidities of kidney stone patients and explore the related factors, so as to provide evidence for clinical prevention and treatment. Methods A retrospective analysis was conducted in 10 140 patients who were diagnosed with kidney stones in The First Affiliated Hospital of Naval Medical University (Second Military Medical University) between Jan. 2017 and Dec. 2020. The patients were divided into unilateral kidney stone group (unilateral group) and bilateral kidney stone group (bilateral group). The age, sex distribution, laboratory examination, and common clinical comorbidities were compared between the 2 groups. Logistic regression was used to explore the related factors that may affect the formation of bilateral kidney stones. Results The mean age of the 10 140 patients was (57.75±13.30) years old, with 276 cases (2.7%) ≤ 30 years old, 6 647 cases (65.6%) 31-64 years old, and 3 217 cases (31.7%) ≥ 65 years old. There were 7 021 males (69.3%) and 3 119 females (30.7%), with a male to female ratio of 2.25:1. The most common clinical complications of the patients in this study included hypertension (3 285 cases, 32.4%), tumor (2 775 cases, 27.4%), hyperuricemia (2 007 cases, 19.8%), diabetes mellitus (1 526 cases, 15.0%), coronary heart disease (1 072 cases,10.6%), and cerebrovascular disease (473 cases, 4.7%). Totally 8 171 patients (80.6%) were in the unilateral group and 1 969 patients (19.4%) in the bilateral group. The age of bilateral group was younger than that of unilateral group, the proportion of male was higher than that of unilateral group, the levels of serum creatinine, uric acid and urine pH were higher than those of unilateral group, the level of high density lipoprotein-cholesterol was lower than that of unilateral group, the proportions of patients with hypertension and hyperuricemia were higher than those of unilateral group, and the proportions of patients with tumor and coronary heart disease were lower than those of unilateral group (all P<0.05). There were no significant differences in body mass index, fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein-cholesterol or the proportion of patients with diabetes or cerebrovascular diseases between the 2 groups (all P>0.05). The results of logistic regression analysis showed that gender (male) and hyperuricemia might be important risk factors for the formation of bilateral kidney stones; however, more patients combined with tumors were seen in the unilateral group (all P<0.05). Conclusion Kidney stones are more common in middle-aged men, and metabolic syndrome-related diseases play an important role in the development of kidney stones, so it is necessary to strengthen the early prevention of these diseases. The incidence of tumor combination is high in patients with kidney stones, suggesting an association between the 2 conditions. In addition, male sex and hyperuricemia are more closely related to the formation of bilateral kidney stones. |
| Key words: kidney calculi clinical comorbidity hyperuricemia neoplasms metabolic syndrome |
