【摘要】 目的 调查分析台州地区尿石症住院患者临床流行病学特点、尿石症对肾功能的损害情况,为该地区尿石症的防治提供依据。方法 根据整体抽样法原则,按台州地区行政区域划分,抽取当地三级医院2018年1月至2020年12月的住院患者,收集尿石症患者占同期住院人数比,患者的性别、年龄、文化程度、职业,尿石症患者与正常人群生化指标比较,尿石症并发肾损害情况等相关数据。所有资料来自各院病案室。结果共抽取台州地区6家医院,共收治住院患者37 022例,其中以尿路结石收治的住院患者14 801例,尿路结石患者占同期泌尿外科总住院患者的39.98%。14 801例患者中,男10 583例(71.50%),女4 218例(28.50%),男女比例为2.51:1;患病高峰年龄段为30～60岁,共9 672例(65.35%);患者职业以农民为主,共5 089例(36.20%)。结果 随机选取600例尿石症患者各项生化指标与正常人群比较,提示尿石症住院患者血糖、尿素氮、肌酐、尿酸、胆固醇、甘油三酯指标均高于正常人群,差异有统计学意义(P<0.01);而两类人群高密度脂蛋白及低密度脂蛋白指标比较,差异无统计学意义(P>0.05)。尿石症患者中吸烟者5 633例(38.06%);体质量指数(body mass index,BMI)<18.50 kg/m~2的患者995例(6.72%),BMI≥18.50～24.00 kg/m~2的患者7 291例(49.26%),BMI>24.00～28.50 kg/m~2的患者4 983例(33.67%),BMI>28.50 kg/m~2的患者1 532例(10.35%);每日饮水量<1 000 ml的患者4 394例(29.69%),1 000～2 000 mL的患者8 901例(60.14%),>2 000 ml的患者1 506例(10.17%);不常运动患者12 033例(81.29%);常精神中高度紧张患者5 532例(37.38%);合并肾绞痛6 991例(47.23%),肾积水5 216例(35.24%),肾功能不全3 790例(25.61%),无功能肾216例(1.46%)。结论 2018—2020年台州地区尿石症仍是泌尿外科最大病种,占同期泌尿外科总住院患者的39.98%,男性患者明显多于女性,高发年龄为30～60岁,最好发职业为农民,部分患者合并肾绞痛、肾积水、肾功能不全甚至无功能肾,可通过控烟、减肥、多饮水、多运动、精神放松等方式减少尿石症发生或复发。更多还原

【Abstract】 Objective This study investigated and analyzed the clinical epidemiological characteristics among inpatients with urolithiasis and the renal function injury due to urolithiasis in the Taizhou region of Zhejiang province,to provide a basis for the prevention and treatment of urolithiasis in this region.Methods According to the principle of cluster sampling,inpatients in Taizhou tertiary hospitals were selected from January 2018 to December 2020,and the proportion of patients with urolithiasis in the same period was determined,including sex,age,education and occupation of the patients;biochemical indexes for patients with urolithiasis versus the normal population;urolithiasis complicated with renalfunction injury and other related data were collected from hospital records.Results A total of 37 022 inpatients were selected from six hospitals in the Taizhou region,including 14 801 inpatients with urinary calculi,which accounted for 39.98% of the total inpatients at the department of urology during the same period.Among the 14 801 cases,10 583(71.50%) were in men,and 4 218(28.50%) were in women.The male-female ratio was 2.51:1.The peak age of urolithiasis was between 30 and 60 years,accounting for a total of 9672 cases(65.35%).A total of 5 089 patients(36.20%) were farmers,the most frequent occupation.Biochemical indicators of 600 patients with urolithiasis were collected and compared with the values in the normal population.The blood glucose,urea nitrogen,creatinine,uric acid,cholesterol and triglycerides among hospitalized patients with urolithiasis were higher than those in the normal population,and the differences were highly significant(P<0.001).However,there was no significant difference in high-density lipoprotein and low-density lipoprotein parameters between the two groups(P>0.05).Among the patients with urolithiasis,5 633(38.06%) were smokers,995(6.72%) patients had BMI <18.50 kg/m~2,7 291(49.26%) patients had BMI≥18.50-24.00 kg/m2,4 983(33.67%) patients had BMI>24.00-28.50 kg/m~2,and 1 532(10.35%) patients had BMI>28.50 kg/m2;4 394(29.69%) patients had daily water intake <1 000 ml,8 901(60.14%) patientshad 1 000-2 000 ml,and 1 506(10.17%) patients had>2 000 ml;12 033(81.29%) patients had infrequent exercise;5 532(37.38%) patients had normal mental high tension;6 991 patients(47.23%) had renal colic,5 216(35.24%) patients had hydronephrosis,3 790(25.61%) had renal insufficiency,and 216(1.46%) patients had no renal function.Conclusion From2018 to 2020,urolithiasis remained the most prevalent disease treated at the department of urology in Taizhou,accounting for 39.98% of all urology inpatients during the same period.Male patients significantly outnumbered female patients,the age of highest incidence was 30-60 years,and the most common occupation was farming.Some patients had renal colic,hydronephrosis,renal insufficiency and even no renal function.The occurrence or recurrence of the disease can be decreased through tobacco control,weight loss,drinking water,physical activity and mental relaxation.更多还原