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目的:探讨上尿路结石患者体质指数(body mass index,BMI)对24 h尿成分及相关血生化指标的影响。方法 :对119例上尿路结石患者进行代谢评估,根据BMI将其分为3组,正常组(18.5≤BMI<24.0,n=37)、超重组(24≤BMI<27,n=52)、肥胖组(27≤BMI,n=30),生化分析系统检测24 h尿钠、钾、钙、磷、尿酸、血钠、血钾、血钙、血磷、血尿酸、尿pH及尿比重等指标,比较组间各指标及代谢异常率的差异性。结果:男性中肥胖、超重组的24 h尿钠、钙、磷、尿酸及血尿酸均明显高于正常组(P<0.05);肥胖组尿pH明显低于超重组和正常组(P<0.05);超重组血磷高于正常组(P<0.05)。女性中肥胖组和超重组24 h尿钙、尿酸均明显高于正常组(P<0.05);肥胖组和超重组尿pH均明显低于正常组(P<0.05);肥胖组24 h尿钠高于正常组(P<0.05)。肥胖组高钠尿症、高钙尿症、高尿酸尿症及合并两种或两种以上代谢异常率明显高于正常组(P<0.05),超重组高钠尿症、高钙尿症及合并两种或两种以上代谢异常率明显高于正常组(P<0.05),而肥胖组的高钙尿症及合并两种或两种以上代谢异常率明显高于超重组(P<0.05)。结论:肥胖及超重对24 h尿成分及相关血生化、尿pH有一定影响,且存在性别差异,对结石病患者尤其是伴肥胖或超重者进行代谢评价是必要的。
Objective: To investigate the effect of body mass index (BMI) on urinary constituents of 24 hours and related blood biochemical parameters in patients with upper urinary tract calculi. Methods: A total of 119 patients with upper urinary tract calculi underwent metabolic assessment. According to BMI, they were divided into three groups: normal group (18.5≤BMI≤24.0, n = 37), overweight group (24≤BMI≤27, n = 52) , Obesity group (27≤BMI, n = 30). The biochemical analysis system was used to detect urinary sodium, potassium, calcium, phosphorus, uric acid, serum sodium, serum potassium, serum calcium, And other indicators, comparing the differences between the indicators and metabolic abnormalities rate. Results: Urinary sodium, calcium, phosphorus, uric acid and serum uric acid in obese and overweight group were significantly higher than those in normal group (P <0.05). The urinary pH in obese group was significantly lower than that in overweight group and normal group (P <0.05) ); Hyperphosphatemia was higher than normal group (P <0.05). The urinary calcium and uric acid in obese group and overweight group were significantly higher than those in normal group (P <0.05). The urinary pH in obese group and overweight group were significantly lower than those in normal group (P <0.05) Higher than the normal group (P <0.05). Hyperuricemia, hypercalciuria, hyperuricaemia and two or more metabolic abnormalities in obesity group were significantly higher than those in normal group (P <0.05), overweight group, hyperuricaemia, hypercalciuria, The combined rate of two or more metabolic abnormalities was significantly higher than that of the normal group (P <0.05), while the incidence of hypercalciuria and metabolic disorders in the obese group was significantly higher than that in the overweight group (P <0.05) . CONCLUSION: Obesity and overweight have certain influence on 24 h urinary composition, related blood biochemistry and urinary pH, and have gender differences. Metabolic evaluation of patients with stone disease, especially those with obesity or overweight, is necessary.