Abstract：
Previous reports show increased severity of perinephric fat stranding (PFS) with elevated serum creatinine in obstructing ureterolithiasis. We sought to investigate this association with our institution\'s patient population.We reviewed charts of patients diagnosed with obstructive ureterolithiasis or nephrolithiasis in our emergency department between January and October 2018. Patient demographics, lab results, and computed tomography (CT) imaging were reviewed. A blinded radiologist reviewed all CTs and graded hydronephrosis and PFS. Subjects were stratified by degree of PFS and compared via paired t-test, chi-squared test, univariate analysis, and multivariate analysis.We identified 141 patients; 114 had no-mild (Group 1) PFS, while 27 had moderate-severe (Group 2) PFS. Group 1 had a mean age of 56 (SD = 16.1) and mean stone size of 7.3 mm (SD = 4.22); 77% of the cohort had symptoms under 24 h. Group 2 was older with a mean age of 65 (SD = 16.2, p = 0.01) and mean stone size of 10.1 mm (SD = 6.07, p < 0.01); 50% had symptoms less than 24 h (p = 0.01). PFS did not correlate with change in serum creatinine. Univariate and multivariate analysis showed increasing age increased the odds of moderate-severe PFS by 3.5% (OR = 1.035, p < 0.05) while increased stone size increased the odds of moderate-severe PFS by 13.7% (OR = 1.137, p = 0.01).Although increased PFS correlated with increased age and stone size, no correlation was found with presenting creatinine or change in creatinine. Degree of PFS is likely a poor predictor of renal disease severity in acute ureterolithiasis.
摘要：
先前的报告显示，在梗阻性输尿管结石中，肾周脂肪绞合（PFS）的严重程度增加，血清肌酐升高。我们试图调查这种与我们机构患者人群的关联。我们回顾了2018年1月至10月在急诊科诊断为梗阻性输尿管结石或肾结石的患者的图表。患者人口统计学，实验室结果,和计算机断层扫描（CT）成像进行了审查。一名失明的放射科医生检查了所有CT和分级肾积水和PFS。受试者按PFS程度分层，并通过配对t检验进行比较。卡方检验，单变量分析，和多变量分析。我们确定了141例患者；114例无轻度（第1组）PFS，而27人患有中重度（第2组）PFS。第1组的平均年龄为56岁（SD=16.1），平均结石大小为7.3mm（SD=4.22）；该队列中有77％的症状在24小时以下。第2组年龄较大，平均年龄为65岁（SD=16.2，p=0.01），平均结石大小为10.1mm（SD=6.07，p<0.01）；50％的症状少于24小时（p=0.01）。PFS与血清肌酐的变化无关。单因素和多因素分析显示，年龄的增加使中重度PFS的几率增加了3.5％（OR=1.035，p<0.05），而结石大小的增加使中重度PFS的几率增加了13.7％（OR=1.137，p=0.01）。尽管PFS的增加与年龄和结石大小的增加相关，未发现与肌酐或肌酐变化相关.PFS程度可能是急性输尿管结石肾脏疾病严重程度的不良预测指标。
