| 摘要: |
| 目的探讨儿童泌尿系结石成分与尿液代谢异常的关系。方法收集结石成分分析、24h尿液定量分析结果完整的147例尿路结石患儿资料，分析患儿结石成分与24h尿液定量分析结果，探讨结石成分与尿液中尿酸、钙盐、胱氨酸、磷酸盐、镁盐、枸橼酸的相关性。结果147例患儿结石成分为混合型结石100例（68.0%），单纯成分尿路结石47例（32.0%）。以草酸钙为主要结石成分的占比最高（72.1%），其次为碳酸磷灰石（10.9%）和尿酸（10.2%）。24h尿液定量分析结果显示109例（74.1%）患儿存在尿液代谢异常；以草酸钙为主要结石成分的患儿，其高钙尿症、高草酸尿症均高于主要成分为尿酸者（均P＜0.05），高草酸尿症发生率高于主要成分为磷酸磷灰石者（P＜0.05），低枸橼酸尿症发生率高于主要成分为磷酸镁铵者（P＜0.05），高尿酸症发生率低于主要成分为尿酸者（P＜0.05）。复发患儿合并代谢异常占92.7%，明显高于无复发患儿的77.1%（P＜0.05）。结论儿童尿路结石成分与尿液代谢异常密切相关；建议处理患儿尿路结石后，及时进行结石成分分析与24h尿液定量分析，再根据患儿尿液代谢检查结果，给予适当的医疗干预。 |
| 关键词: 尿路结石 24h 尿液定量分析 尿液代谢 |
| DOI： |
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| 基金项目:杭州市医疗卫生科研项目（20140633B14） |
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| Composition of urinary stone and its relation to metabolic disturbance in children with urolithiasis |
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ZHU Jingyu, LI Ruipeng, WANG Yanbin, PAN Huixian
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Hangzhou Third People's Hospital
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| Abstract: |
| Objective To study the chemical composition of urinary stones and its relation to metabolic disturbance in children with urolithiasis. Methods The chemical composition of urinary stones was detected and 24h urine was analyzed in 147 children with urolithiasis. The correlation between composition of urinary stones and metabolic disturbance was investigated. Results Of all 147 patients, there were 47 cases (32.0% ) with single composition stones and 100 cases (68.0% ) with mixed composition stones, in which most was calcium oxalate as the major component (72.1%), followed by phosphate(10.9%) and urate (10.2%). Metabolic disturbance was found in 109 cases (74.1% ). Among the patients with calcium oxalate stone, the rates of hypocitraturia，hypercalciuria and hyperoxaluria were significantly higher than those in other groups. Conclusion Urinary stone of children is closely related to metabolic disturbances. Stone composition analysis and metabolic evaluation are important in etiological diagnosis, as well as in treatment and prevention of urinary stones. |
| Key words: Urolithiasis stone 24h urine analysis Metabolic evaluation |
