不同体质指数尿路结石患者结石化学成分分析（附850例报告）

目的观察不同体质指数（BMI）尿路结石患者结石化学成分。方法根据我国BMI标准，将850例尿路结石患者分为正常组（BMI〈24）245例、超重组（BMI24—27）327例、肥胖组（BMI≥28）278例。采用傅立叶红外光谱法分析其结石化学成分。结果850例中，结石成分为草酸钙、磷酸钙、尿酸、磷酸镁铵者分别为645（75．9％）、128（15．1％）、52（6．1％）、25（2．9％）例。其中尿酸结石患者平均年龄均高于其他结石成分患者（P〈0．05），男性比例显著高于女性（P〈0．05）；磷酸铵镁结石男性比例低于女性（P〈0．01）。正常组、超重组、肥胖组中，草酸钙结石者分别为70．2％、78．0％、78．4％（P〈0．05），尿酸结石者分别为2．9％、7．0％、7．9％（P〈0．05），磷酸镁铵结石者分别为7．3％、1．2％、1．1％（P〈0．01），三组磷酸钙结石比例相近（P〉0．05）。结论BMI对结石成分有一定的影响；超重及肥胖的结石患者中，尿酸、草酸钙结石比例显著高于BMI正常的结石患者；尿酸、草酸钙结石患者应注意控制体质量。

Analysis of stone components urinary stone patients with different BMI

Objective To study urinary stone components in urinary stone patients with different body mass index （BMI）. Methods In 850 urinary stone patients, 245 were normal weight group （BMI 〈 24）, 327 were overweight group （ BMI 24 - 27 ）, and 278 were obese group （ BMI≥28 ） according to Chinese guideline. Physical analysis of stone compnents were carried out by the Fourier transform infrared spectroscop） （FT-IP）. Results hi 850 patients, the FT-IR evalaation showed that 645 cases （75.9%） were calcium oxalate stones, followed by calcium phosphate stones 128 cases （15.1%）, uric acid stones 52 cases （6. 1% ） and struvite 25 cases （2.9%）. Uric aeid stone formers were more elder than with other components （ P 〈 0.05 ）. Uric acid was the major components more frequent in men （ P 〈 0.05 ）, while struvite was more frequent in women （P 〈 0.01 ） . The prevalence of calcium oxalate stones in the normal weight, overweight and obese groups were 70.2% , 78.0% and 78.4% , respectively （ P 〈 0.05 ） ; the prevalence of uric acid stones in the different groups was 2.9% , 7.0% , and 7.9%, respectively （P 〈 0.05 ）, and that of struvite was 7.3%, 1.2% and 1.1% , respectively （P 〈 0.01 ）. There was no significant deference in prevalence of calcium phosphate stone formers with different BMI（P 〉 0.05 ）. Conclusions The prevalence of urinary stone disease is found to be associated with BMI. The percentages of uric acid and calcium oxalate stones are higher in overweight and obese group than in normal one. Uric acid and calcium oxalate stone patients are suggested to keep body weight in normal range.