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中华腔镜泌尿外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (05) : 481 -485. doi: 10.3877/cma.j.issn.1674-3253.2023.05.011

临床研究

腹主动脉钙化患者肾结石成分特点及危险因素分析
徐哲, 罗杰, 吴强, 李忠, 王晓伟, 郑硕, 郝晓东, 王照†()   
  1. 050000　石家庄，河北医科大学第一医院泌尿外科
    641100　四川，内江市第二人民医院泌尿外科
  • 收稿日期:2022-09-20 出版日期:2023-10-01
  • 通信作者: 王照
  • 基金资助:
    河北省卫生健康委科研基金项目(20160708); 河北省中医药管理局科研计划项目(2020165)

Analysis of the composition characteristics and risk factors of kidney stones in patients with abdominal arterial calcification

Zhe Xu, Jie Luo, Qiang Wu, Zhong Li, Xiaowei Wang, Shuo Zheng, Xiaodong Hao, Zhao Wang†()   

  1. Department of Urology, the First Hospital of Hebei Medical University, Shijiazhuang 050000, China
    Department of Urology the Second People's Hospital of Neijiang City, Sichuan 641100, China
  • Received:2022-09-20 Published:2023-10-01
  • Corresponding author: Zhao Wang
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引用本文：

徐哲, 罗杰, 吴强, 李忠, 王晓伟, 郑硕, 郝晓东, 王照. 腹主动脉钙化患者肾结石成分特点及危险因素分析[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(05): 481-485.

Zhe Xu, Jie Luo, Qiang Wu, Zhong Li, Xiaowei Wang, Shuo Zheng, Xiaodong Hao, Zhao Wang. Analysis of the composition characteristics and risk factors of kidney stones in patients with abdominal arterial calcification[J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(05): 481-485.

目的

探讨腹主动脉钙化（AAC）患者肾结石成分特点及其形成的危险因素。

方法

选择2021年1月至2022年2月河北医科大学第一医院90例AAC合并肾结石患者为观察组，随机抽取同期体检中心AAC未合并肾结石患者为对照组（88例）。分析观察组结石成分特点，比较两组一般临床资料，采用Logistic回归分析AAC患者形成肾结石的独立危险因素。

结果

观察组结石成分主要为草酸钙结石22例（24.44%）和草酸钙+碳酸磷灰石30例（33.33%）。单因素分析显示观察组男性（P=0.033）、合并高血压（P<0.001）、合并糖尿病（P=0.004）、有吸烟史（P=0.039）患者人数明显多于对照组；血胆固醇（P=0.038）、低密度脂蛋白胆固醇（LDL-C） （P=0.023）、血尿酸（P=0.006）明显高于对照组，高密度脂蛋白胆固醇（HDL-C）明显低于对照组（P=0.001）。Logistic回归分析显示：合并高血压、低HDL-C、高LDL-C及高血尿酸是AAC患者肾结石形成的独立危险因素（OR>1，P<0.05）。

结论

AAC患者肾结石成分主要以草酸钙结石、草酸钙+碳酸磷灰石为主，高血压、低HDL-C、高LDL-C、高血尿酸均是AAC患者形成肾结石的独立危险因素，临床应早期筛查其潜在危险因素并采取相关措施。

关键词: 腹主动脉钙化, 肾结石, 结石成分, 危险因素
Objective

To investigate the composition characteristics and risk factors of renal stone in patients with abdominal aortic calcification (AAC).

Methods

From January 2021 to February 2022, 90 patients with AAC complicated with kidney stones in the First Hospital of Hebei Medical University were selected as the observation group, randomly selected patients with AAC without nephrolithiasis in the physical examination center during the same period as the control group (88 cases). The characteristics of stone composition in the observation group were analyzed, and the clinical data and biochemical indexes of the two groups were compared. Binary Logistic regression was used to analyze the independent risk factors of renal stone formation in patients with AAC.

Results

The stones in the observation group were mainly composed of calcium oxalate stones in 22 cases (24.44%) and calcium oxalate+carbonated apatite in 30 cases (33.33%). Univariate analysis showed that in the observation group, the proportion of patients with male (P=0.033), hypertension (P<0.001), diabetes (P=0.004), smoking history (P=0.039), TC (P=0.038), LDL-C (P=0.023), blood uric acid (P=0.006) were significantly higher than those in the control group, and HDL-C was significantly lower than that in the control group(P=0.001). Logistic regression analysis showed that hypertension, low HDL-C, high LDL-C and hyperuricemia were independent risk factors for renal stone formation in patients with AAC (OR>1, P<0.05).

Conclusions

The main components of kidney stones in patients with AAC are calcium oxalate stones, calcium oxalate+carbonated apatite. Hypertension, low HDL-C, high LDL-C, and hyperuricemia are independent risk factors for the formation of kidney stones in patients with AAC. Potential risk factors should be screened early in clinical practice and relevant measures should be taken.

Key words: Abdominal aortic calcification, Kidney calculi, Stone composition, Risk factors
表1 90例腹主动脉钙化合并肾结石患者结石成分分析
结石成分 例数 构成比（%）
单一结石 32 35.56
草酸钙结石 22 24.44
磷酸钙结石 1 1.11
碳酸磷灰石 4 4.44
尿酸结石 5 5.56
混合结石 58 64.44
草酸钙+磷酸钙结石 12 13.33
草酸钙+碳酸磷灰石 30 33.33
草酸钙+尿酸结石 3 3.33
草酸钙+磷酸钙+碳酸磷灰石 4 4.44
草酸钙+磷酸钙+尿酸结石 6 6.67
草酸钙+尿酸+碳酸磷灰石 3 3.33
表2 178例腹主动脉钙化患者一般资料及实验室指标比较
组别 例数 年龄(岁) 男性[例(%)] 女性[例(%)] BMI(kg/m2) 合并高血压[例(%)] 合并糖尿病[例(%)] 有吸烟史[例(%)]
观察组 90 57(51，63) 63(70.00) 27(30.00) 25.70(22.97，27.43) 53(58.89) 20(22.22) 32(35.56)
对照组 88 63(36，66) 48(54.55) 40(45.45) 25.13(23.01，27.48) 19(21.59) 6(6.82) 19(21.59)
统计值   Z=0.914 χ2=4.582 Z=0.428 χ2=25.697 χ2=8.464 χ2=4.245
P值   0.361 0.033 0.669 <0.001 0.004 0.039
组别 有饮酒史[例(%)] TC(mmol/L) 高TC[例(%)] HDL-C(mmol/L) 低HDL-C[例(%)] LDL-C(mmol/L) 高LDL-C[例(%)]
观察组 23(25.56) 4.9±1.1 18(20.00) 0.97(0.86，1.14) 49(54.44) 3.10(2.55，3.55) 11(12.22)
对照组 20(22.73) 4.6±1.0 8(9.09) 1.11(0.99，1.26) 27(30.68) 2.78(2.21，3.27) 2(2.27)
统计值 χ2=0.194 t=2.087 χ2=4.245 Z=3.319 χ2=10.269 Z=2.274 χ2=6.506
P值 0.659 0.038 0.039 0.001 0.001 0.023 0.011
组别 血肌酐(μmol/L) 血白蛋白(g/L) 血尿酸(μmol/L) 高血尿酸[例(%)] 血尿素氮(mmol/L) 血钙(mmol/L) TG(mmol/L)
观察组 73(62，88) 40±4 435(318，489) 48(53.33) 5.61(4.49，6.65) 2.35(2.29，2.41) 1.31(0.97，1.90)
对照组 75(64，90) 41±4 354(288，426) 22(25.00) 5.35(4.14，6.65) 2.35(2.27，2.42) 1.25(0.92，1.75)
统计值 Z=0.239 t=1.965 Z=2.751 χ2=14.970 Z=0.914 Z=0.389 Z=0.560
P值 0.811 0.051 0.006 <0.001 0.361 0.698 0.575
表3 腹主动脉钙化患者发生肾结石的危险因素Logistic回归分析
因素 β值 SE值 Wald值 OR值 P值 95%CI
性别 0.116 0.419 0.076 1.122 0.783 0.493~2.553
合并高血压 1.183 0.381 9.634 3.264 0.002 1.546~6.889
合并糖尿病 0.762 0.565 1.823 2.143 0.177 0.709~6.480
有吸烟史 0.728 0.447 2.657 2.071 0.103 0.863~4.972
高TC 0.112 0.616 0.033 1.119 0.855 0.334~3.746
低HDL-C 0.760 0.372 4.177 2.139 0.041 1.032~4.434
高LDL-C 2.248 0.980 5.259 9.468 0.022 1.386~64.659
高血尿酸 0.962 0.376 6.538 2.618 0.011 1.252~5.475
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