摘要
目的：探讨血脂异常与泌尿系结石形成的相关性。方法收集2015年1月至2016年5月就诊的427例泌尿系结石患者的临床资料（结石组），男272例（63.7％），女155例（36.3％）。年龄43～63岁，平均53岁。肾结石218例（35.6％），输尿管结石158例（25.8％），肾结石伴发输尿管结石23例（3.8％），膀胱结石28例（4.6％）。收集同期年龄、性别匹配的950例体检正常者的临床资料（对照组），男570例（60％），女380例（40％）。年龄48～60岁，平均53岁。对照组均经泌尿B超检查排除泌尿系结石。观察两组人群血脂水平的差异以及血脂异常在结石患者中的发病率，分析血脂水平与血尿酸、尿pH和结石成分的相关性并进行Logistic回归分析。结果结石组平均总胆固醇、三酰甘油、高密度脂蛋白分别为4.34 mmol／L、1.38 mmol／L、1.25 mmol／L，对照组分别为4.32 mmol／L、1.09 mmol／L、1.40 mmol／L，两组比较差异有统计学意义（ P＜0.05）。结石组平均低密度脂蛋白为2.63 mmol／L，与对照组2.65 mmol／L比较差异无统计学意义（ P＝0.241）。结石组427例中，135例（31.6％）有血脂异常。血脂异常组和血脂正常组的平均尿酸值分别为392、339μmol／L，尿pH值分别为5、6，两组比较差异有统计学意义（P＜0.05）。结石组中193例行结石成分分析，包括血脂异常者63例（32.6％），其中尿酸结石31例（49.2％）；血脂正常者130例（67.4％），尿酸结石40例（30.8％），两者尿酸结石所占比例比较差异有统计学意义（ P＝0.013）。相关性分析显示血脂异常与高血尿酸水平、低尿pH值密切相关（r＝0.226、r＝－0.597，P＜0.001）。多因素校正的Logistic回归分析显示三酰甘油为泌尿系结石形成的独立危险因素（ P＝0.001）。结论血脂异常尤其是高三酰甘油血症与泌尿系结石发生密切相关。
Objective To explore the relationship between dyslipidemia and urinary stone formation.Methods The clinical data of 427 patients diagnosed with urolithiasis in our hospital during January 2015 to May 2016 were collected.Among them,272 men accounting for 63.7%,155 women account for 36.3%.The average age were 53 （43-63）.218 cases were kidney stones,accounting for 35.6%;158 cases were ureteral calculi, accounting for 25.8%; 23 cases were kidney stones with ureteral calculi, accounting for 3.8%;28 cases were bladder calculi, accounting for 4.6%.At the same time,950 age and gender matched healthy controls were collected.Among them,570 men accounting for 60%, 380 women account for 40%.The average age were 53 （ 48-60 ）.All of them had undergone renal ultrasound to excluded urolithiasis.The difference between lipid level and incidence of dyslipidemia in patients with urolithiasis were observed. The relationship between lipid level and serum UA, urine pH and stone composition was evaluated and analyzed with logistic regression.Results The average serum TC,TG,HDL-C levels of patients with urolithiasis were 4.34mmol/L, 1.38mmol/L, 1.25mmol/L, which levels were 4.32mmol/L,1.09mmol/L,1.40mmol/L in healthy controls.Significant difference were seen between the two groups （ P 〈0.05 ）.The average serum LDL-C was 2.63mmol/L in patients with urolithiasis and 2.65mmol/L in healthy controls.No difference were seen between the two groups （ P=0.241）.31.6% of patients with urolithiasis had different degree of dyslipidemia.The average serum UA levels,urine pH value of patients with dyslipidemia were 392μmol/L and 5,which were 339μmol/L and 6 in patients with normal lipid level.Significant difference were seen between the two groups （ P〈0.05 ）.Among 193 patients who had stone composition analysis, 130 cases had normal lipid level, accounting for 67.4%; 63 cases had dyslipidemia, accounting for 32.6%.In 63 patients with calculi who had dyslipidemia,31 cases had uric acid calculi,accounting for 49.2%.In 130 patient
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2016年第9期698-702,共5页
Chinese Journal of Urology
