多囊肾病继发结石的危险因素分析

The Risk Factors for Secondary Stone Formation in Polycystic Kidney Disease

摘要: 目的：探究常染色体显性遗传性多囊肾病(Autosomal Dominant Polycystic Kidney Disease, ADPKD)继发结石的危险因素。方法：回顾性选取2017年9月至2025年4月期间在安徽医科大学第四附属医院(安徽医科大学附属巢湖医院)的203例常染色体显性遗传性多囊肾病(ADPKD)住院患者作为研究对象，再按照有无继发结石进行分组，将其分为结石组和无结石组。收集两组患者的临床资料，分析ADPKD患者合并泌尿系结石的独立危险因素。结果：203例ADPKD患者中继发结石的有92例，单因素分析结果显示，血尿酸、肾脏总体积、交联性囊肿、囊肿压迫输尿管、丙氨酸氨基转移酶(Alanine Aminotransferase, ALT)、尿比重、优势囊肿体积可纳入多因素Logistic回归分析中(P < 0.05)，多因素回归分析显示，囊肿压迫输尿管、ALT、尿比重、优势囊肿体积是ADPKD继发结石的独立危险因素(P < 0.05)。此外，将ALT、优势囊肿体积与结石发生率进行相关性分析显示，ALT与结石发生率呈高度正相关(r = 0.978)，优势囊肿体积与结石发生率也呈高度正相关(r = 0.933)。结论：囊肿压迫输尿管、ALT、尿比重、优势囊肿体积是ADPKD继发结石的独立危险因素，其中ALT、优势囊肿体积与结石发生率高度相关。

Abstract: Objective: To investigate the risk factors for secondary stone formation in autosomal dominant polycystic kidney disease (ADPKD). Methods: The study involved the retrospective selection of two hundred and three patients with autosomal dominant polycystic kidney disease (ADPKD) admitted to The Fourth Affiliated Hospital of Anhui Medical University (Chaohu Hospital of Anhui Medical University) between September 2017 and April 2025. These patients were then categorized into two groups based on whether they had secondary stones or not: the stone group and the stone-free group. The clinical data of the two groups were gathered to examine the independent risk factors for mixed urinary stones in patients with ADPKD. Results: Of the 203 ADPKD patients, 92 got secondary stones. Univariate analysis showed that blood uric acid (BUA), total volume of the kidney, Communicating Cyst. The cyst is compressing the ureter, Alanine aminotransferase (ALT), urine specific gravity, and dominant cyst volume could be included in the multifactorial logistic regression analysis (P < 0.05). The multifactorial regression analysis revealed that the independent risk factors for secondary stone formation in ADPKD were the cyst is compressing the ureter, ALT, urine specific gravity, and dominant cyst volume (P < 0.05). In addition, correlation analysis of ALT, dominant cyst volume and stone incidence showed that ALT was highly positively correlated with stone incidence (r = 0.978), and dominant cyst volume was also highly positively correlated with stone incidence (r = 0.933). Conclusion: The influencing factors of secondary stones in ADPKD are the cyst is compressing the ureter, ALT, urine-specific gravity, and dominant cyst volume. ALT and dominant cyst volume are highly correlated with the incidence of stones, which has some predictive value for these patients.