代谢综合征对泌尿系结石术后留置双J管患者附管结石发生风险的影响分析

Analysis of the Influence of Metabolic Syndrome on the Risk of Urinary Calculi in Patients with Postoperative Indwelling Double J Tubes

摘要: 目的：探讨代谢综合征(MS)对泌尿系结石术后留置双J管患者附管结石发生风险的影响。方法：选取2022年10月至2023年10月本院行泌尿系结石术后留置双J管的79例患者作为研究对象，根据代谢指标检查结果将患者分为MS组(58例)与非MS组(21例)，收集患者一般资料、实验室指标，返院拔除双J管时确认患者术后附管结石发生情况，采用单因素、多因素Logistic回归分析附管结石发生危险因素。结果：MS组高血压、糖尿病、高脂血症、吸烟史的患者占比体重指数及拔管时的SBP、FBG、UA、TC、TG、LDL-C、hs-CRP水平均高于非MS组，HDL-C低于非MS组(P < 0.05)；术后留置双J管的患者附管结石发生率为27.85% (22/79)，其中MS组附管结石发生率34.48% (20/58)高于非MS组9.52% (2/21) (P < 0.05)；MS组附管结石为尿酸结石的例数占比为34.48% (20/58)，高于非MS组的9.52% (2/21) (P < 0.05)；单因素分析显示：发生附管结石患者留置双J管时间长于未发生患者，糖尿病、尿结晶、尿蛋白阳性占比及拔管时的FBG、UA、hs-CRP水平均高于未发生患者(P < 0.05)；回归分析显示：留置尿管时间较长、存在尿蛋白及拔管时高水平的FBG、UA、hs-CRP均是附管结石发生的危险因素(P < 0.05)。结论：MS与双J管术后附管结石的形成密切相关，可作为术后结石发生的独立预测因素，此外留置尿管时间较长、存在尿蛋白及拔管时高水平的FBG、UA、hs-CRP均是附管结石发生的危险因素，通过对MS高危人群早期生活方式的干预，有助于降低发病风险。

Abstract: Objective: To investigate the effect of metabolic syndrome (MS) on the risk of tubular stones in patients with postoperative urinary calculi after indentation of double J tubes. Methods: From October 2022 to October 2023, 79 patients who underwent urinary calculi surgery with double J tubes were selected as the study objects. According to the results of metabolic indexes, the patients were divided into MS group (58 cases) and non-MS group (21 cases). General data and laboratory indexes of the patients were collected. After the double-J tube was removed, the occurrence of tubular stones was confirmed, and the risk factors of tubular stones were analyzed by univariate and multivariate Logistic regression. Results: The proportion of patients with hypertension, diabetes, hyperlipidemia and smoking history in MS group and the levels of SBP, FBG, UA, TC, TG, LDL-C and hs-CRP at extubation were higher than those in non-MS group, and HDL-C was lower than those in non-MS group (P < 0.05). The incidence of tubulariasis was 27.85% (22/79) in patients with double J tubes after operation, and the incidence of tubulariasis in MS group was 34.48% (20/58) higher than that in non-MS group 9.52% (2/21) (P < 0.05). The proportion of uric acid calculi in MS group was 34.48% (20/58), which was higher than 9.52% (2/21) in non-MS group (P < 0.05). Unifactor analysis showed that patients with tubulization had longer induration time than those without tubulization, and the levels of diabetes, urine crystal, urine protein positive and FBG, UA and hs-CRP at extubation were higher than those without tubulization (P < 0.05). Regression analysis showed that long catheter indwelling time, presence of urinary protein and high levels of FBG, UA and hs-CRP during extubation were risk factors for tubular stones (P < 0.05). Conclusion: MS is closely related to the formation of tubular stones after double-J tube surgery, and can be used as an independent predictor of the occurrence of postoperative stones. In addition, long catheter indwelling time, presence of urinary protein and high level of FBG, UA and hs-CRP during extubation are risk factors for tubular stones. Early life style intervention in high-risk people with MS can help reduce the risk of morbidity.