背景:尽管接受了有效的治疗,但仍有几乎一半的患者复发性肾结石。我们的目标是确定对肾结石进行腔内治疗后结石的复发率,并确定这些复发的危险因素。
方法:回顾性收集了2014年5月至2017年1月在我院接受腔内治疗的所有肾结石患者的数据。将患者分为两组:有复发和无复发。还比较了这两组之间的许多变量。
结果:在此期间,265例患者接受了上尿路结石治疗。共有190名患者被纳入研究。患者的中位年龄和中位BMI分别为57.5岁和25.2kg/m2。对117例(61.5%)患者进行了结石的生化分析。最常见的结石类型是草酸钙一水合物结石(n=44,23.2%),混合结石(n=39,20.5%),包括混合草酸钙(n=10;8.5%),草酸钙二水结石(n=13,6.8%)和尿酸结石(n=11,5.8%)。在32个月的中位随访结束时(范围,13-61个月),49例(25.8%)结石复发。在单变量分析中,复发的危险因素是BMI大于25kg/m2(HR:2;P<0.05),糖尿病(HR:3.73;P<0.008)和吸烟(HR:3.1;P<0.039)。然而年龄(HR:0.96:P<0.003)和高血压(HR:0.37;P<0.027)是保护因素。在多变量分析中,糖尿病,吸烟,高血压,和年龄仍然是复发的危险因素。
结论:处理泌尿系结石后结石复发很常见。在这项研究中,25.8%的患者经过腔内治疗后复发结石,中位随访时间为32个月。我们的研究结果表明,糖尿病和吸烟是复发的危险因素,而年龄和高血压是降低复发风险的保护性因素。
BACKGROUND: Almost half of the patients have had recurrent nephrolithiasis despite undergoing effective treatment. Our objective is to determine the recurrence rate of lithiasis after endourological management of nephrolithiasis and identify the risk factors for these recurrences.
METHODS: Data were gathered retrospectively from all patients who were treated for nephrolithiasis by endourological management from May 2014 to January 2017 in our university hospital. The patients were devised into two groups: with and without recurrence. Many variables were also compared between these two groups.
RESULTS: During this period 265 patients were treated for upper urinary tract stone. A total of 190 patients were included in the
study. The median age and median BMI of the patients were 57.5 years and 25.2kg/m2, respectively. A biochemical analysis of the stones was performed in 117 (61.5%) patients. The most common types of stones were calcium oxalate monohydrate stones (n=44, 23.2%), mixed stones (n=39, 20.5%) including mixed calcium oxalate (n=10; 8.5%), calcium oxalate dihydrate stones (n=13, 6.8%) and uric acid stones (n=11, 5.8%). At the end of a median follow-up of 32 months (range, 13-61 monthes), 49 patients (25.8%) had a recurrent stone. In univariate analysis, the risk factors for recurrence were BMI greater than 25kg/m2 (HR: 2; P<0.05), diabetes (HR: 3.73; P<0.008) and smoking (HR: 3.1; P<0.039). However age (HR: 0.96: P<0.003) and high blood pressure (HR: 0.37; P<0.027) were protective factors. In multivariate analysis, diabetes, smoking, hypertension, and age are still risk factors for recurrence.
CONCLUSIONS: Stone recurrence is common after the management of urinary stones. In this
study 25.8% of patients had recurred stone disease after endourological management with a median follow-up of 32 months. Our
study findings showed that diabetes and smoking are risk factors for recurrence, while age and blood hypertension are protective factors that decreased the risk of recurrence.