Zhong Qingtao,Zhang Deying,Wang Xuan,et al.Analysis of risk factors and causes of early recurrence of children with upper urinary tract calculi[J].Journal of Clinical Pediatric Surgery,2023,22(07):635-641.[doi:10.3760/cma.j.cn101785-202211008-007]
儿童上尿路结石危险因素及早期复发原因分析
- Title:
- Analysis of risk factors and causes of early recurrence of children with upper urinary tract calculi
- Keywords:
- Urolithiasis; Risk Factors; Recurrence; Surgical Procedures; Operative; Child
- 摘要:
- 目的 探讨儿童上尿路结石（upper urinary tract calculi，UUTC）的危险因素及早期复发原因。方法 回顾性分析2017年1月至2021年4月重庆医科大学附属儿童医院泌尿外科确诊为UUTC患儿（结石组，n=129）以及同期住院的非UUTC患儿（非结石组，n=130）临床资料，对比两组人口学特征、结石病家族史、饮食饮水及排尿情况等。采用单因素和多因素Logistic回归模型筛选儿童UUTC的独立危险因素，并分析各因素对UUTC患儿早期复发的影响。结果 129例UUTC患儿中，男性81例、女性48例，就诊年龄（7.58±4.02）岁。高钠饮食（OR=4.199，95%CI：1.418~12.440）、高钙摄入（OR=5.043，95%CI：1.720~14.788）、低饮水量（OR=2.691，95%CI：1.125~6.435）、低排尿量（OR=2.462，95%CI：1.108~5.470）、结石病家族史（OR=2.041，95%CI：1.137~3.664）、先天性上尿路畸形（OR=7.133，95%CI：1.420~35.817）是儿童UUTC的独立危险因素。结石早期复发率为8.5%（11/129），早期复发原因依次是原发性高草酸尿症（3/6）、胱氨酸尿症（2/6）、低排尿量（1/6）。结论 高钠饮食、高钙摄入、低饮水量、低排尿量、结石病家族史、先天性上尿路畸形与儿童UUTC发生有关；遗传代谢性疾病、低排尿量是儿童UUTC早期复发的主要原因。
- Abstract:
- Objective To explore the risk factors of upper urinary tract calculi (UUTC) and identify the causes of early recurrence in children.Methods For this case-control study, clinical data were retrospectively reviewed for 129 UUTC children at Children’s Hospital of Chongqing Medical University from January 2017 to April 2021.They were assigned into two groups of UUTC (case, n=129) and non-UUTC (control, n=130).Social demographics, family history of calculi, dietary intake, water intake and urination were compared.Univariate and multivariate Logistic regression analyses were performed for identifying the independent risk factors and examining the effect of each factor on early recurrence of UUTC.Results There were 81 boys and 48 girls with an age range of (7.58±4.02) years.Logistic regression analysis indicated that high sodium diet(OR=4.199, 95%CI:1.418~12.440), high calcium intake(OR=5.043, 95%CI:1.720~14.788), low water intake(OR=2.691, 95%CI:1.125~6.435), low urinary output(OR=2.462, 95%CI:1.108~5.470), a family history of UUTC(OR=2.041, 95%CI:1.137~3.664) and congenital abnormalities of upper urinary tract(OR=7.133, 95%CI:1.420~35.817) were independent risk factors for UUTC in children.The early recurrence rate of calculi was 8.5%(11/129) and the causes for early recurrence were primary hyperoxaluria (3/6), cystinuria (2/6) and low urinary output (1/6).Conclusion High sodium diet, high calcium intake, low water intake, low urinary output, a family history of UUTC and congenital malformation of upper urinary tract are correlated closely with UUTC in children.Inherited metabolic diseases and low urinary output are the major causes of early recurrence.
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备注/Memo
收稿日期:2022-11-05。
基金项目:重庆市科卫联合项目（2019GDRC007）；重庆市渝中区科学技术局基础研究与前沿探索项目（20200126）；重庆医科大学未来医学青年创新团队支持计划（W0056）；重庆市科卫联合中医药技术创新与应用发展项目（2020ZY023877）
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