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·论著·

河北省不同地理环境上尿路结石成分分布特点研究

常学良，王亚轩，李景东，张艳平，滕志海，韩振伟 * 扫描二维码
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【摘要】 背景 泌尿系结石是泌尿系统常见病、多发病，其中上尿路结石最为常见，给患者造成沉重负担。上
尿路结石成因复杂，与性别、年龄、地理位置、气候、饮食等密切相关，不同地理环境患者的结石成分是否存在差异
仍不清楚。目的 分析河北省不同地理环境上尿路结石成分，为临床上尿路结石的治疗及预防提供依据。方法 收集
2019 年于河北医科大学第二医院门诊进行体外冲击波碎石和住院手术取出结石的患者资料，获取 1 192 例患者的上尿
路结石标本，使用红外光谱法对结石成分进行定量和定性分析，分析河北省山区、平原、沿海地区患者的结石成分特点。
结果 上尿路结石患者高发年龄为 30~70 岁，男女比例约为 1.75∶1，肾结石与输尿管结石占比相当（约为 1.1∶1），
结石成分以混合性结石为主（61.5%）。三种地理环境上尿路结石均以含钙结石为主，以一水草酸钙为最多。感染性
结石在山区、平原地区及沿海地区的占比比较，差异无统计学意义（P>0.05）。平原地区的尿酸结石占比与山区及沿
海地区比较，差异均有统计学意义（P<0.05）。结论 河北省三种地理环境上尿路结石分布均以含钙结石为主，山区
及沿海地区尿酸结石占比较高，需引起泌尿外科医生的注意。
【关键词】 尿路结石；结石成分；地理位置；河北
【中图分类号】 R 691.4 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2021.01.601
常学良，王亚轩，李景东，等 . 河北省不同地理环境上尿路结石成分分布特点研究［J］. 中国全科医学，2022，25（2）：
171-174. ［www.chinagp.net］
CHANG X L，WANG Y X，LI J D，et al. Geographic variability of upper urinary tract stone constituents in Hebei
adults［J］. Chinese General Practice，2022，25（2）：171-174.

Geographic Variability of Upper Urinary Tract Stone Constituents in Hebei Adults CHANG Xueliang，WANG Yaxuan，
LI Jingdong，ZHANG Yanping，TENG Zhihai，HAN Zhenwei *
Department of Urology，the Second Hospital of Hebei Medical University，Shijiazhuang 050000，China
*
Corresponding author：HAN Zhenwei，Associate professor，Master supervisor；E-mail：hanzhenwei1101@126.com
【Abstract】 Background Urinary stones are a common and frequently-occurring disease of the urinary system，
among which upper urinary tract stones are the most common，imposing a heavy burden on patients. The causes of upper urinary
tract stones are complex，which are closely associated with gender，age，geographic condition，climate，diet，and so on.
However，it is still unclear whether upper urinary stone constituents vary by geographical conditions. Objective To analyze the
constituents of upper urinary tract stones among adults in different geographic regions of Hebei，providing evidence for clinical
treatment and prevention of upper urinary tract stones. Methods Outpatients and inpatients（n=1 192，≥ 18 years old） with
upper urinary calculis who were from three geographical regions （mountainous，plain and coastal） of Hebei were selected from
the Second Hospital of Hebei Medical University in 2019. Upper urinary tract stones of the outpatients removed by extracorporeal
shock wave lithotripsy，and those of the inpatients removed by surgery were collected for quantitative and qualitative constituent
analyses by geographical region using infrared spectrometry. Results Upper urinary tract stones were more often found in those
30 to 70 years old，with a male to female ratio about 1.75∶1. Kidney stones and ureteral stones accounted for similar proportions
（about 1.1∶1），and the mixed stones were more common （61.5%）. Calcium-containing stones were the major type of
upper urinary tract stones in participants from each geographic regions，with calcium oxalate monohydrate being the most. The
prevalence of infectious stones showed no significant differences across participants from three regions（P>0.05）. The prevalence
of uric acid-containing stones in participants from plain was significantly different from that of participants from mountainous or
coastal region（P<0.05）. Conclusion Calcium-containing stones were the most common prevalent in upper urinary tract stones
patients across three geographic regions of Hebei，and the prevalence of uric acid-containing stones in those from mountainous or
coastal region was higher，which require the attention of urologists.
【Key words】 Urinary calculi；Stone constituents；Geographic locations；Hebei

基金项目：河北省卫生健康委医学科学研究课题计划项目（20190048；20210756）
050000 河北省石家庄市，河北医科大学第二医院泌尿外科
*
通信作者：韩振伟，副教授，硕士生导师；E-mail：hanzhenwei1101@126.com
本文数字出版日期：2021-11-26