【摘要】 目的:分析以草酸钙成分为主的肾盏憩室结石患者的临床及影像学特征，探讨代谢及解剖因素在其结石形成中的作用。方法:采用病例对照研究设计，将2020年7月—2024年11月在郑州大学第二附属医院泌尿外科经影像或手术确诊的27例以草酸钙成分为主的肾盏憩室结石患者作为病例组，选取同期30例以草酸钙成分为主的正常肾结石患者作为对照组。收集临床资料、影像学数据、24 h尿液代谢数据，并进行分析比较。结果:病例组有92.59%(25/27)的患者存在≥1种代谢异常，以低枸橼酸尿症(66.67%)、低尿量(66.67%)为主。对照组有90.00%(27/30)的患者存在代谢异常，以低枸橼酸尿症(63.33%)、低尿量(26.67%)为主。病例组24 h尿量低于对照组(P=0.001),低尿量发生率显著高于对照组(P=0.001),低尿量是草酸钙型肾盏憩室结石的独立危险因素；病例组24 h尿草酸排泄量低于对照组(P=0.027),2组高草酸尿症发病率比较差异无统计学意义(P>0.05);病例组结石最大CT值低于对照组(P=0.002);2组结石位置分布差异有统计学意义(P=0.004)。2组高钙尿症、高磷尿症、低镁尿症等指标的发生率比较差异无统计学意义(P>0.05)。结论:病例组普遍存在24 h尿液代谢紊乱情况。代谢因素可能与解剖因素一样在肾盏憩室结石中具有重要作用，其中低草酸排泄量可能与其结石最大CT值降低有关。更多还原

【Abstract】 Objective: To analyze the clinical and imaging characteristics of patients with calyceal diverticular stones predominantly composed of calcium oxalate, and to investigate the role of metabolic and anatomical factors in stone formation. Methods: A case-control study design was employed. Patients with urinary calculi predominantly composed of calcium oxalate who presented to the Department of Urology, The Second Affiliated Hospital of Zhengzhou University between July 2020 and November 2024 were enrolled. Twenty-seven patients with calyceal diverticular stones predominantly composed of calcium oxalate, confirmed by imaging or surgery, served as the case group. Thirty contemporaneous patients with normal renal stones predominantly composed of calcium oxalate were collected as the control group. Clinical data, imaging data, and 24-hour urine metabolic data were collected and comparatively analyzed. Results: The case group exhibited metabolic abnormalities in 92.59%(25/27) of patients, predominantly hypocitraturia(66.67%) and low urine volume(66.67%), while the control group showed metabolic abnormalities in 90.00%(27/30), primarily hypocitraturia(63.33%) and low urine volume(26.67%). Significant intergroup differences were observed: the case group had lower 24-hour urine volume(P=0.001) and a higher incidence of low urine volume(P=0.001), identifying low urine volume as an independent risk factor for calcium oxalate stones in calyceal diverticula. Additionally, 24-hour urinary oxalate excretion was lower in the case group(P=0.027), though hyperoxaluria incidence showed no statistical difference(P>0.05). The maximum CT attenuation value of stones was significantly lower in the case group(P=0.002), and stone location distribution differed between groups(P=0.004). No significant differences were found in the incidence of hypercalciuria, hyperphosphaturia, or hypomagnesuria(P>0.05). Conclusion: Patients in the case group commonly exhibited metabolic derangements in 24-hour urine profiles. Metabolic factors may play an equally important role as anatomical factors in stone formation within calyceal diverticula. Among these, lower urinary oxalate excretion may be associated with a reduction in the maximum CT value of their stones.更多还原