简体中文

·腹部疾病·

基于血清电解质和尿常规的青年战士上尿路结石风险方程的建 立*

作者:韩 刚 张 倩 陈宇东

所属单位:中国人民解放军第二五二医院泌尿外科 (河北 保定 071000)

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摘要

目的 探讨血清电解质及尿比重、pH值与青年战士上尿路结石的相关性。方法 回顾性分析255例因上尿路结石住院 治疗的青年战士临床资料,另选377例同期体检的健康青年战士作为对照,比较两者血清钾(K)、钠(Na)、氯(Cl)、 钙(Ca)、二氧化碳结合力(CO2-CP)、尿比重(SG)和pH值的差异,并构建Logistic回归方程。结果 与对照组相比, 结石组血清K和尿pH值偏低,而Na、Cl、Ca和SG偏高。经Logistic回归后得到青年战士上尿路结石风险方程Y=exp(- 140.56-1.91×K+0.36×Na+4.25×Ca-1.59×pH+92.72×SG)/[1+exp(-140.56-1.91×K+0.36×Na+4.25×Ca1.59×pH+92.72×SG)]。血清K和尿pH值是青年战士上尿路结石的保护因素,而Na、Ca和SG则是危险因素。结论 血 清K、Na、Ca、尿pH和SG可能参与上尿路结石的发生过程,风险方程的应用有助于该疾病的个体化防治。

Objective To explore risk factors and development of upper urinary tract lithiasis in young soldiers by assessing the relevance between serum electrocyte, routine urine test. Methods 255 young soldiers suffered from upper urinary tract lithiasis were involved in this research. Other 377 health young soldiers were considered as control. Serum levels of K, Na, Cl, Ca, CO2-CP, and urine pH and urine specific gravity (SG) were analyzed between these two groups. Results There was significant difference in serum K, Na, Cl, Ca, urine pH, and SG. Logisitic regression analyses showed that K and urine pH were protective factors, while Na, Ca, and SG were risk factors for upper urinary tract lithiasis in young soldiers. The risk equation was established by logistic regression:Y=exp(-140.56-1.91×K+0.36×Na+4.25×Ca1.59×pH+92.72×SG)/[1+exp(-140.56-1.91×K+0.36×Na+4.25×Ca-1.59×pH+92.72×SG)]. Conclusions Serum K, Na, Ca, and urine pH and SG may play role in pathogenesis of upper urinary tract lithiasis, and the use of risk equation may contribute to preventing and curing this disease with individualized pattern.

【关键词】上尿路结石;青年战士;电解质;尿常规

【中图分类号】R649.4

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2016.03.010

前言

上尿路结石是部队常见病,严重影响部队官兵的 健康和战斗力。钾(K)、钠(Na)、氯(Cl)、钙(Ca)等 电解质离子在成石过程中发挥重要作用[1]。本文对患 上尿路结石的青年战士血清电解质及尿常规进行回顾 性分析,为了解该人群上尿路结石的成因和防治提供 依据。