| Introduction : Urinary calculi(UrinaryCalculus)have become a global problem.Due to their different socio-economic status and geographical location,their incidence rate and prevalence rate are increasing worldwide.In East Asia and North Asia,the incidence rate is 1%-8%,and the recurrence rate of urinary calculi is very high.The recurrence rate is 21% to 53% after 3-5 years.In particular,metabolic syndrome(MS)may be one of the risk factors for urolithiasis.Objective: Through the comparison of the relationship between sm and non SM patients and urinary calculi,and through the analysis of urinary calculi to understand the composition of calculi,to explore the risk factors related to the occurrence of stones and to make guidance and suggestions for recurrent stones.Method:A retrospective analysis was made of 189 cases of urolithiasis diagnosed and operated in the same group of physicians in urology department of the First Affiliated Hospital of Nanhua University from May 2018 to December 2019.There were 104 males and 85 females.According to the diagnostic criteria of metabolic syndrome of the International Diabetes League in 2006,the patients were divided into two groups: the group with metabolic syndrome(MS group,case group)and the group without metabolic syndrome(non MS group,control group).At the same time,the patients with MS uric acid calculus were treated with potassium hydrogen citrate and sodium citrate(the observation group took the medicine continuously for 4 months,n = 27)or not(the control group,n = 22),After 12 months follow-up,the recurrence rate of stones and urinary biochemistry were observed.Spss25.0 software was used to analyze the clinical data collected.Result: In this study,we found that calcium oxalate monohydrate has the highest detection rate,170 cases(89.9%)of calcium oxalate monohydrate,69 cases in MS group and 101 cases in non MS group.Calcium oxalate dihydrate was found in 65 cases(34.3%),23 cases in MS group and 42 cases in non MS group.Calcium oxalate dihydrate and calcium oxalate monohydrate were found at the same time and could not be detected alone.Carbonate apatite was found in 105 cases(55.5%),38 in MS group and 67 in non MS group.There were 70 cases of anhydrous uric acid(37.0%),53 cases in MS group and 17 cases in non MS group.There were 17 cases(8.9%)of magnesium ammonium phosphate hexahydrate,6 cases in MS group and 11 cases in non MS group.The majority of patients had mixed stones,a total of 152(80.4%),64 cases in MS group,88 cases in non MS group,and the single stone was mainly calcium oxalate monohydrate.There was significant difference between MS group and non-ms2 group in anhydrous uric acid(P<0.05).Among them,diabetic patients have 2.467 times more uric acid calcium calculi(UA)than non diabetic patients.The incidence of UA in obese patients was 1.545 times higher than that in non patients,and high-density lipoprotein cholesterol(HDL-C)might be the protective factor of UA.The recurrence rate of the patients with MS who took orally potassium citrate and sodium citrate was significantly lower than that of the patients without MS(P = 0.032 < 0.05).The pH,uric acid,citric acid and calcium in urine in the observation group were higher than those in the control group(P < 0.05).Conclusion: MS can increase the prevalence of uric acid stones.Diabetes or hyperglycemia may be the main risk factors of UA.Potassium hydrogen citrate may effectively reduce the recurrence rate of UA patients with MS. |
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