【摘要】 目的 调查肾结石患者血清维生素D水平，并探讨肾结石发生机制与维生素D的关系。方法 选取2019年6月至2024年1月在安徽医科大学第二附属医院通过经皮肾镜取石术或输尿管镜取石的肾结石患者584例(结石组)和同期无肾结石的健康志愿者113例(对照组),对2组研究对象血清维生素D水平进行调查和比较。584例肾结石患者中草酸钙结石397例(草酸钙结石组),感染性结石112例(感染性结石组),尿酸结石75例(尿酸结石组)。比较不同结石成分患者血清维生素D水平和各种参数，分析肾结石患者血清维生素D水平与甲状旁腺激素的关系。结果 结石组患者平均25羟维生素D[25(OH)D]水平明显低于对照组[(21.56±9.24)ng/mL vs.(29.31±7.15)ng/mL],维生素D不足和缺乏者占比明显高于对照组[49.14%(287/584)vs. 15.04%(17/113)],结石组男性患者血清25(OH)D水平明显高于女性[(23.79±9.36)ng/mL vs.(17.38±7.38)ng/mL],差异均有统计学意义(P<0.001);血清25(OH)D水平与年龄呈正相关(r=0.21,P<0.001)。感染性结石组患者血清维生素D水平最低，维生素D不足和缺乏者占比最高，差异均有统计学意义(P<0.05)。血清25(OH)D水平与甲状旁腺激素呈明显负相关(r=-0.20,P<0.001)。结论 大多数肾结石患者血清维生素D水平处于不足或缺乏状态，尤其是感染性结石患者。将血清维生素D水平作为肾结石患者代谢评估中的必选指标有利于结石的预防及整体健康状况的维护。更多还原

【Abstract】 Objective To investigate the serum vitamin D level in patients with kidney stones, and to explore the relationship between the mechanism of kidney stones and vitamin D.Methods A total of 584 patients with kidney stones(the stone group) and 113 healthy volunteers without kidney stones(the control group) who underwent percutaneous nephrolithotomy or ureteroscopic stone removal in the Second Hospital of Anhui Medical University from June 2019 to January 2024 were enrolled to investigate and compare the serum vitamin D levels of the two groups.Among the 584 patients with kidney stones, 397 cases were calcium oxalate stones(calcium oxalate stone group),112 cases were infectious stones(infectious stone group),and 75 cases were uric acid stones(uric acid stone group).The serum vitamin D levels and various parameters of patients with different stone components were compared, and the relationship between serum vitamin D levels and parathyroid hormone in patients with kidney stones was analyzed.Results The average level of 25 hydroxyvitamin D [25(OH)D] in the stone group was significantly lower than that in the control group[(21.56±9.24)ng/mL vs.(29.31±7.15)ng/mL],the proportion of vitamin D insufficiency and deficiency was significantly higher than that in the control group[49.14%(287/584) vs. 15.04%(17/113)],and the serum 25(OH)D level in the stone group was significantly higher than that in women[(23.79±9.36)ng/mL vs.(17.38±7.38)ng/mL],and the difference was statistically significant(P<0.001).Serum 25(OH)D level was positively correlated with age(r=0.21,P<0.001).The serum vitamin D level was the lowest in the infectious stone group, and the proportion of vitamin D insufficiency and deficiency was the highest, and the difference was statistically significant(P<0.05).Serum 25(OH)D level was negatively correlated with parathyroid hormone(r=-0.20,P<0.001).Conclusion Most patients with kidney stones have insufficient or deficient serum vitamin D levels, especially those with infectious stones.Serum vitamin D level is a mandatory indicator in the metabolic evaluation of patients with kidney stones, which is beneficial for the prevention of stones and the maintenance of overall health.更多还原