| Objective: To analyze the incidence of urinary calculi and the characteristics of the affected population,and the distribution characteristics of the stone composition in the Tujia and Miao Autonomous Prefecture of Xiangxi,and explore the relationship between the incidence of the stone,the location of the stone,the composition of the stone and the age,gender,ethnicity,etc.To get a general understanding of the epidemiology of urinary calculi in the Tujia-Miao Autonomous Prefecture of Xiangxi,and provides an important theoretical basis for individualized dietary guidance,oral drug selection and reasonable prevention and treatment measures for clinical stone patients in this area,so as to achieve the goal of reducing the recurrence rate of urinary calculi.Methods: A retrospective analysis of 1810 consecutive cases of urinary calculi in the Department of Urology,Xiangxi Prefecture People’s Hospital,First Affiliated Hospital of Jishou University from June 2013 to April 2020.All patients were from Xiangxi Prefecture,and the stone specimens were all obtained after the patients discharged themselves or the stones were discharged after ESWL,ureterotomy or nephrostomy,URL,LL,RIRS,PCNL and other surgical treatments.The stone component analysis methods are all obtained by infrared spectroscopy,and the system collects all The clinical data of the patient to which the specimen belongs(including gender,age,ethnicity,history of urinary calculi and previous surgery,stone location,stone composition,etc).Comparative analysis of the incidence of urinary calculi in Xiangxi Prefecture,the location of the calculi,the composition of the calculi,and the relationship between age,gender,and ethnicity.Results: 1.Among the 1810 patients with urinary calculi in the Tujia and Miao Autonomous Prefecture of Xiangxi Prefecture,males(1069 cases,59.06%)were significantly more than females(741 cases,40.94%),and the ratio of the two was 1.44:1.The average age of onset of urinary calculi was 49.5years.2.According to the location of urinary calculi,there were significantly more upper urinary tract stones(1673 cases,92.43%)than lower urinary tract stones(137cases,7.57%).Lower urinary tract stones were 131 males(12.25%)and females 6(0.81%).The incidence rate of males was significantly higher than that of females,and the difference was statistically significant(P=0.000<0.05).Divided by age,the youth group(18-65 years old)and the juvenile group(≤17 years old)were mainly composed of kidney stones,738 cases(47.52%)and 20 cases(66.67%).and in the middle-aged group(66-79 years old),patients were predominantly with ureteral stones,76 cases(36.72%);while the elderly group(≥80 years old)was predominantly with lower urinary tract stones,a total of 12 cases(60.00%);different age groups were distributed among the stone sites The difference was statistically significant(P=0.000<0.05).Divided by ethnicity,there are 882 cases(48.73%)of Tujia nationality,575 cases(31.77%)of Miao nationality,and 348 cases(19.23%)of Han nationality.The three groups are mainly kidney stones,accounting for 45.80%,47.13% and 40.52 of the current group respectively.%,there was no statistical difference in the location of stones among the above three different ethnic groups(P=0.113>0.05).3.In this study,there were 1086 cases of mixed stones(59.01%)and 742 cases(40.99%)of single component stones.Among them,mixed stones were mainly COM+COD,totaling 380Cases(34.99%);followed by COM+COD+ Dah,339 cases(31.22%);single-component stones are composed of COM Mainly,a total of 570 cases(78.73%),followed by Ur,a total of 103 cases(14.23%).Grouped by age group,calcium oxalate stones are the predominant group in each age group;uric acid stones account for a higher proportion in the juvenile group and the elderly group,and the other groups are higher,with 12cases(40.00%)and 6 cases(30.00%),respectively In the youth group and the middle-aged group,infectious stones accounted for a higher proportion than other groups,514 cases(33.10%)and 63 cases(30.43%)respectively;there were differences in the formation of urinary calculi in different age groups,which was statistically significant(P=0.000<0.05).According to gender,the incidence of uric acid stones in men(15.81%)was higher than that in women(9.31%),and the difference was statistically significant(P=0.000<0.05).The incidence of infectious stones in women(24.43%)was higher than that in men(16.35%),and the incidence rate was statistically different among different sexes(P=0.000<0.05).Divided by ethnicity,calcium oxalate stones accounted for the highest proportion among all ethnic groups.Tujia,Miao and Han people accounted for 801 cases(90.82%),511 cases(88.87%)and 317 cases(91.09%)respectively;uric acid stones The incidence was the lowest,with 115 cases(13.04%),76 cases(13.22%),46 cases(13.22%)in the three groups respectively;infectious stones were in the middle,with 267 cases(30.27%)and 197 cases(34.26%)in the three groups respectively)And 92 cases(26.44%);there were statistical differences in the incidence of infectious stones among the three different ethnic groups(P=0.04<0.05),calcium oxalate stones(P=0.783>0.05)and uric acid stones(P=0.994)>0.05)There is no statistical difference in the incidence rate among the above three ethnic groups.Conclusions:1.Urinary stones above the urinary tract in the areas where the Tujia and Miao nationalities live in Xiangxi Prefecture,mainly concentrated in middle-aged and young(especially 36-65 years old)patients,with more men than women.2.The proportion of men in lower urinary tract stones is significantly higher than that of women,and the proportion of elderly group is significantly higher than that of other age groups.3.The incidence of urinary calculi in each ethnic group is roughly similar to that of the population of all ethnic groups in this region.There is no significant difference in the location of urinary calculi in Tujia,Miao and Han nationalities.4.In this region,the incidence of calcium oxalate stones is the highest,followed by infectious stones and uric acid stones.Among them,women are relatively more likely to suffer from infectious stones,while men are relatively more likely to suffer from uric acid stones.5.Tujia and Miao nationalities are more susceptible to infectious stones than Han nationalities,but there is no significant difference in the incidence of calcium oxalate stones and uric acid stones among ethnic groups.The formation mechanism and influencing factors are still unclear.The analysis of stone composition is of great significance for exploring the epidemiology of urinary calculi in Xiangxi Prefecture,the distribution of stone composition and the prevention and treatment of calculi. |
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