切换至 "中华医学电子期刊资源库"

中华腔镜泌尿外科杂志(电子版) ›› 2024, Vol. 18 ›› Issue (04) : 361 -365. doi: 10.3877/cma.j.issn.1674-3253.2024.04.010

临床研究

尿酸结石的危险因素分析及双能量CT特征研究
江杰1, 沈城1, 潘永昇1, 陈新风1, 刘振民1, 朱华1,(), 郑兵1   
  1. 1. 226001 江苏,南通大学第二附属医院泌尿外科
  • 收稿日期:2022-10-09 出版日期:2024-08-01
  • 通信作者: 朱华
  • 基金资助:
    南通市卫健委科研课题(MB2021025); 南通市"十四五"科教强卫工程(重点57); 南通市科技计划项目(M'S22022085)

Analysis of risk factors and dual-energy CT features of uric acid calculi

Jie Jiang1, Cheng Shen1, Yongsheng Pan1, Xinfeng Chen1, Zhenmin Liu1, Hua Zhu1,(), Bing Zheng1   

  1. 1. Department of Urology, The Second Affiliated Hospital of Nantong University, Jiangsu 226001, China
  • Received:2022-10-09 Published:2024-08-01
  • Corresponding author: Hua Zhu
引用本文:

江杰, 沈城, 潘永昇, 陈新风, 刘振民, 朱华, 郑兵. 尿酸结石的危险因素分析及双能量CT特征研究[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 361-365.

Jie Jiang, Cheng Shen, Yongsheng Pan, Xinfeng Chen, Zhenmin Liu, Hua Zhu, Bing Zheng. Analysis of risk factors and dual-energy CT features of uric acid calculi[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(04): 361-365.

目的

分析尿酸结石患者的临床特征,探讨尿酸结石形成的危险因素及双能量CT预测尿酸结石的价值。

方法

回顾性分析2017年3月至2020年11月于南通大学第二附属医院泌尿外科就就诊的75例尿酸结石患者的临床资料,并将同时期75例无结石病史的体检人群设为对照组,分析比较两组的临床特征,并进一步采用Logistic回归分析尿酸结石形成的危险因素。同时对双能量CT预测尿酸结石的敏感度和特异度进行分析。

结果

与对照组相比,尿酸结石组的男性比例更多、尿液pH更低、尿路感染的可能性更大;血肌酐、血钙、血钠、血尿酸比对照组高;多因素Logistic回归分析显示男性、尿液低pH、高血钙、高血尿酸是尿酸结石形成的危险因素。双能量CT预测尿酸结石的敏感度为97.44%,特异度为100%。

结论

尿酸结石的形成可能与性别、尿液pH、血钙、血尿酸有关;双能量CT可以对尿酸结石进行一定程度的预测。

Objective

To analyze the clinical characteristics of patients with uric acid stones, explore the risk factors for uric acid stone formation, and evaluate the value of dual-energy CT in predicting uric acid stones.

Methods

A retrospective analysis was conducted on the clinical data of 75 patients with uric acid stones who visited the Department of Urology at the Second Affiliated Hospital of Nantong University from March 2017 to November 2020. A control group was set up with 75 healthy individuals who had no history of stones during the same period. The clinical characteristics of the two groups were analyzed and compared, and the risk factors for the formation of uric acid stones were further analyzed using logistic regression. Simultaneously analyze the sensitivity and specificity of dual-energy CT in predicting uric acid stones.

Results

Compared with the control group, the uric acid stone group had a higher proportion of males, lower urine pH, and a higher likelihood of urinary tract infections. Blood creatinine, calcium, sodium, and uric acid were higher in the control group than in the control group. Multivariate Logistic regression analysis showed that male, low urine pH, high blood calcium, and high blood uric acid were risk factors for the formation of uric acid stones. The sensitivity and specificity of dual-energy CT for predicting uric acid stones are 97.44% and 100%, respectively.

Conclusions

The formation of uric acid stones may be related to gender, urine pH, blood calcium, and blood uric acid. Dual-energy CT can predict uric acid stones to a certain extent.

表1 尿酸结石组与无结石病史体检人群(对照组)一般资料比较
表2 尿酸结石组与无结石病史体检人群(对照组)尿常规结果比较
表3 尿酸结石组与无结石病史体检人群(对照组)生化代谢指标比较
表4 尿酸结石形成的多因素Logistic回归分析
图1 三组血尿酸浓度比较注:对照组为无结石病史的体检人群,尿酸结石组血尿酸浓度均高于对照组(P<0.001)
表5 双能量CT预测尿酸结石的敏感度及特异度(例)
[1]
Skolarikos A, Jung H, Neisius A, et al. EAU Guidelines on urolithiasis [EB/OL].[2024-04-08].

URL    
[2]
Wang K, Ge J, Han W, et al. Risk factors for kidney stone disease recurrence: a comprehensive meta-analysis[J]. BMC Urol, 2022, 22(1): 62.
[3]
Forbes CM, McCoy AB, Hsi RS. Clinician versus nomogram predicted estimates of kidney stone recurrence risk[J]. J Endourol, 2021, 35(6): 847-852.
[4]
Cicerello E. Uric acid nephrolithiasis: an update[J]. Urologia, 2018, 85(3): 93-98.
[5]
Tran TVM, Maalouf NM. Uric acid stone disease: lessons from recent human physiologic studies[J]. Curr Opin Nephrol Hypertens, 2020, 29(4): 407-413.
[6]
Chen HW, Chen YC, Lee JT, et al. Prediction of the uric acid component in nephrolithiasis using simple clinical information about metabolic disorder and obesity: a machine learning-based model[J]. Nutrients, 2022, 14(9): 1829.
[7]
Wang Z, Zhang Y, Zhang J, et al. Recent advances on the mechanisms of kidney stone formation (Review)[J]. Int J Mol Med. 2021, 48(2): 149.
[8]
Schwaderer AL, Raina R, Khare A, et al. Comparison of risk factors for pediatric kidney stone formation: the effects of sex[J]. Front Pediatr, 2019, 7: 32.
[9]
Sorokin I, Mamoulakis C, Miyazawa K, et al. Epidemiology of stone disease across the world[J]. World J Urol, 2017, 35(9): 1301-1320.
[10]
Bargagli M, Ferraro PM, Vittori M, et al. Calcium and vitamin D supplementation and their association with kidney stone disease: a narrative review[J]. Nutrients, 2021, 13(12): 4363.
[11]
Wagner CA. Etiopathogenic factors of urolithiasis[J]. Arch Esp Urol, 2021, 74(1): 16-23.
[12]
Zeng G, Zhu W, Robertson WG, et al. International Alliance of Urolithiasis (IAU) Guidelines on the metabolic evaluation and medical management of urolithiasis[J]. Urolithiasis, 2022, 51(1):4.
[13]
Trinchieri A, Montanari E. Biochemical and dietary factors of uric acid stone formation[J]. Urolithiasis, 2018, 46(2): 167-172.
[14]
Espinosa-Ortiz EJ, Eisner BH, Lange D, et al. Current insights into the mechanisms and management of infection stones[J]. Nat Rev Urol, 2019, 16(1): 35-53.
[15]
Choy SH, Nyanatay SA, Sothilingam S, et al. Cardiovascular risk factors, ethnicity and infection stone are independent factors associated with reduced renal function in renal stone formers[J]. PLoS One, 2022, 17(4): e0265510.
[16]
Williams JC Jr, Gambaro G, Rodgers A, et al. Urine and stone analysis for the investigation of the renal stone former: a consensus conference[J]. Urolithiasis, 2021, 49(1): 1-16.
[17]
Borofsky MS, Handa RK, Evan AP, et al. In vivo renal tubule pH in stone-forming human kidneys[J]. J Endourol, 2020, 34(2): 203-208.
[18]
Kim JC, Cho KS, Kim DK, et al. Predictors of uric acid stones: mean stone density, stone heterogeneity index, and variation coefficient of stone density by single-energy non-contrast computed tomography and urinary pH[J]. J Clin Med, 2019, 8(2): 243.
[19]
Nourian A, Ghiraldi E, Friedlander JI. Dual-energy CT for urinary stone evaluation[J]. Curr Urol Rep, 2020, 22(1): 1.
[20]
Appel E, Thomas C, Steuwe A, et al. Evaluation of split-filter dual-energy CT for characterization of urinary stones[J]. Br J Radiol, 2021, 94(1127): 20210084.
[21]
Carbone A, Al Salhi Y, Tasca A, et al. Obesity and kidney stone disease: a systematic review[J]. Ital J Urol Nephrol, 2018, 70(4): 393-400.
[22]
Wollin DA, Skolarikos A, Preminger GM. Obesity and metabolic stone disease[J]. Curr Opin Urol, 2017, 27(5): 422-427.
[23]
Prasanchaimontri P, Monga M. Predictive factors for kidney stone recurrence in type 2 diabetes mellitus[J]. Urology, 2020, 143: 85-90.
[24]
Kim S, Chang Y, Jung HS, et al. Glycemic status, insulin resistance, and the risk of nephrolithiasis: a cohort study[J]. Am J Kidney Dis, 2020, 76(5): 658-668.e1.
[1] 明昊, 肖迎聪, 巨艳, 宋宏萍. 乳腺癌风险预测模型的研究现状[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(05): 287-291.
[2] 庄燕, 戴林峰, 张海东, 陈秋华, 聂清芳. 脓毒症患者早期生存影响因素及Cox 风险预测模型构建[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(05): 372-378.
[3] 黄鸿初, 黄美容, 温丽红. 血液系统恶性肿瘤患者化疗后粒细胞缺乏感染的危险因素和风险预测模型[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(05): 285-292.
[4] 罗文斌, 韩玮. 胰腺癌患者首次化疗后中重度骨髓抑制的相关危险因素分析及预测模型构建[J/OL]. 中华普通外科学文献(电子版), 2024, 18(05): 357-362.
[5] 贺斌, 马晋峰. 胃癌脾门淋巴结转移危险因素[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 694-699.
[6] 林凯, 潘勇, 赵高平, 杨春. 造口还纳术后切口疝的危险因素分析与预防策略[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 634-638.
[7] 杨闯, 马雪. 腹壁疝术后感染的危险因素分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 693-696.
[8] 周艳, 李盈, 周小兵, 程发辉, 何恒正. 不同类型补片联合Nissen 胃底折叠术修补食管裂孔疝的疗效及复发潜在危险因素[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 528-533.
[9] 冀旭, 朱峰, 冯业晨. 保留器官功能的胰腺切除术后胆道并发症发生危险因素分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 509-514.
[10] 张伟伟, 陈启, 翁和语, 黄亮. 随机森林模型预测T1 期结直肠癌淋巴结转移的初步研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 389-393.
[11] 司楠, 孙洪涛. 创伤性脑损伤后肾功能障碍危险因素的研究进展[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(05): 300-305.
[12] 颜世锐, 熊辉. 感染性心内膜炎合并急性肾损伤患者的危险因素探索及死亡风险预测[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 618-624.
[13] 李文哲, 王毅, 崔建, 郑启航, 王靖彦, 于湘友. 新疆维吾尔自治区重症患者急性肾功能异常的危险因素分析[J/OL]. 中华卫生应急电子杂志, 2024, 10(05): 269-276.
[14] 刘志超, 胡风云, 温春丽. 山西省脑卒中危险因素与地域的相关性分析[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 424-433.
[15] 曹亚丽, 高雨萌, 张英谦, 李博, 杜军保, 金红芳. 儿童坐位不耐受的临床进展[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(05): 510-515.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?
CN/1674-3253/bottom_cn.htm"-->