Objective To study the relationship between 24 h urinary ion content and kidney stones in patients with primary gout.Methods The research method was retrospective analysis.The observation object were 200 patients with primary gout admitted to Guang'an People's Hospi-tal from January 2021 to January 2023.Ultrasonic examination showed that 122 of 200 patients with idiopathic gout had kidney calculi(kidney cal-culi positive group)and 78 patients had no kidney calculi(kidney calculi negative group).One hundred and sixty cases had urate crystal deposi-tion in lower limb joints;DECT diagnosed 68 cases of urate stones(DECT positive group)and 132 cases without kidney calculi(DECT negative group).The clinical and ultrasound imaging data of the kidney calculi positive group and the kidney calculi negative group,as well as the DECT positive group and the DECT negative group were compared,the correlation between urine ion content and kidney calculi and the risk factors of kidney calculi formation were analyzed.At the same time,the results of dual-energy CT(DECT)images were taken as the gold standard for the diagnosis of renal urate stones,and the diagnostic value of urine ion content for gout complicated with renal urate stones was analyzed.Results The course of gout in the kidney calculi positive group was(83.91±30.53)months,which was significantly longer than that in the kidney calculi negative group[(48.64±26.52)months],the total 24-hour urine oxalate was(28.54±20.63)mg/24 hours,which was significantly higher than that in the kidney calculi negative group[(20.09±9.74)mg/24 hours],the total 24-hour urine citrate was(355.63±219.52)mg/24 hours,which was significantly lower than that in the kidney calculi negative group[506.24±315.32)mg/24 hours],and the differences were statistically significant(P＜0.05).The course of gout in the DECT positive group was(108.23±72.14)months,which was significantly longer than that in the DECT negative group[49.05±28.31)months],blood uric acid,total 24-hour urine oxalate,total 24-hour urine uric acid were(522.98±109.14)μmol/L,(28.47±10.71)mg/24 h,(1 684.11±811.08)mmol/24 h,respectively,which were significantly higher than those in the DECT negative group[(479.36±103.32)μmol/L,(23.54±10.82)mg/24 h,(1 517.81±886.53)mmol/24 h],the total 24-hour urine citrate was(391.63±261.14)mg/24 h,which was significantly lower than that in the DECT non negative group[(555.91± 316.24)mg/24 h],and the differences were statistically significant(P＜0.05).Logistic regression analysis showed that the main risk factors of kidney calculi in patients with primary gout were low 24-hour urine citric acid,high blood uric acid and long gout course(P＜0.05).The main risk factors of renal urate stones in patients with primary gout are low total 24-hour urine citric acid,high serum creatinine and long gout course(P＜0.05).Conclusion Primary gout patients with renal urate stones have the characteristics of high total 24-hour urine oxalate and low total 24 h urine citrate.The total 24 h urine oxalate and total 24-hour urine citrate have good diagnostic value for gout accompanied by renal urate stones.Low total 24-hour urine citrate and long gout course are important risk factors for kidney calculi in patients with primary gout.
关键词
原发性痛风/24h尿液离子含量/肾结石/诊断价值
Key words
Primary gout/24 h urine ion content/Kidney calculi/Diagnostic value
维普
万方数据