بررسی فراوانی نسبی سنگ‌های کلیوی از نظر ترکیب سنگ در بیماران مراجعه کننده به سنگ شکن

نوع مقاله : Original Article(s)

نویسندگان

1 استادیار، گروه ارولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشجوی پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: سنگ کلیه یک بیماری بسیار شایع می‌باشد که حدود 7-4 درصد مردم جهان به آن مبتلا هستند؛ میزان بروز سنگ کلیه در ایران از حداکثر میزان جهانی بیشتر است. انواع مختلفی از سنگ‌ها وجود دارد و جنس سنگ بسیار وابسته به عادات تغذیه‌ای جامعه می‌باشد. به طور کلی دانستن جنس سنگ کمک بسیاری در پیش‌گیری، درمان (به خصوص درمان دارویی) و تشخیص می‌کند و به پزشک این اجازه را می‌دهد که در هر یک از این زمینه‌ها به طور اختصاصی عمل کند. از این رو بر آن شدیم تا با بررسی فراوانی نسبی سنگ‌های کلیوی از نظر ترکیب سنگ در بیماران مراجعه کننده به سنگ شکن گامی در این زمینه برداریم.روش: این مطالعه‌ی توصیفی- تحلیلی در مرکز آموزشی درمانی نور اصفهان انجام شد. روش نمونه گیری آسان بود و حجم نمونه با در نظر گرفتن این که 10 درصد بیماران پس از سنگ شکن سنگ خود را دفن نمی‌کنند، 234 نفر محاسبه شد. داده‌های مطالعه در یک پرسش‌نامه‌ی دو قسمتی وارد شد. این اطلاعات به وسیله‌ی نرم‌افزار 15SPSS مورد تجزیه و تحلیل قرار گرفت. آزمون‌های آماری مورد استفاده شامل آزمون 2χ و آزمون دقیق فیشر (جهت مقایسه‌ی داده‌های کیفی) و آزمون Student-t (جهت مقایسه‌ی داده‌های کمی) بود.یافته‌ها: در این مطالعه، سنگ‌های دفع شده از 234 نفر طور دقیق آنالیز شد. 25 نفر (7/10 درصد) دارای سنگ اگزالات کلسیم، 4 نفر (7/1 درصد) دارای سنگ فسفات کلسیم، 1 نفر (4/0 درصد) دارای سنگ اسید اوریک و 205 نفر (6/87 درصد) دارای سنگ مخلوط بودند. در 95 نفر (46 درصد) از افراد دارای سنگ مخلوط، جنس سنگ اگزالات کلسیم + فسفات کلسیم، در 34 نفر (17 درصد) اگزالات کلسیم + فسفات کلسیم + اسید اوریک، در 24 نفر (12 درصد) فسفات کلسیم + اسید اوریک، در 10 نفر (5 درصد) اگزالات کلسیم + اسید اوریک و در 9 نفر (4 درصد) اگزالات کلسیم + استرووایت بود.نتیجه‌گیری: سنگ‌های مخلوط فراوانی بیشتری نسبت به سایر سنگ‌ها داشتند و با نگاه دقیق‌تر و آنالیز دقیق سنگ‌های کلیه متوجه این نکته شدیم که قسمت اعظم سنگ‌های مخلوط از سنگ کلسیمی تشکیل شده است؛ البته سنگ‌های اسید اوریکی و استرووایی (به طور خالص) نسبت به سایر مطالعات بسیار کمتر بود که علت، مناسب نبودن این نوع سنگ‌ها برای سنگ شکن می‌باشد؛ این سنگ‌ها اغلب تحت درمان دارویی قرار می‌گیرند.

کلیدواژه‌ها

عنوان مقاله [English]

The Prevalence of Kidney Stone Different Composition in Patients Referred to the Lithotripsy Wards

نویسندگان [English]

  • Farhad Tadayyon 1
  • Mehdi Sabbagh 2
1 Assistant Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Medical Student, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: kidney stone is a very common disease with the prevalence of 4-7% in the world. The rate of this disease in Iran is more than maximum amount through other countries. There are variety renal stones which different factors and conditions have a hand in formation of each kind of them. Type of stone is so many impressed by diet and nutritional habits. So it is important to analysis the composition of renal stone in different nations to prevent the formation of stone or to stop its enlargement. Also, the first choice for diagnosing renal stone is the most sensitive method; so knowing about the kind of prevalent stones will help to save time and costs. This study aimed to find relative frequency of kidney stones considering their composition in patients referred to lithotripsy wards.Methods: This cross-sectional study was done in Noor hospital, Isfahan. Data was gathered in a two-part questionnaire. The first part about complementary information was filled by researcher via face to face interview at hospital. After two weeks, the second part was filled by calling patients and asking them whether the stone was exerted or not. When the stone was exerted, the patients were asked to give the stone to laboratory for analysis. If the stone had not been exerted the patient were followed until three months later. The number of subjects estimated by statistical formula was 200 but 240 patients was studied because in some of them, the stone might be not exerted. The data were analyzed by SPSS using chi-square and Student-t tests.Conclusion: In this study, the exerted stone of 234 patients were exactly analyzed. The relative frequency of renal stone in men was more that women. The most popular age of renal stone was 3rd to 5th decade of life. 25 patients (10.7%) had Ca oxalate stone, 4 (1.7%) had Ca phosphate stone, 1 (0.4%) had uric acid stone, and 205 patients (87.6%) had mixed stone. From patients with mixed stone, 95 (46%) had Ca oxalate + Ca phosphate stone, 34 (17%) had Ca oxalate + Ca phosphate + uric acid stone, 24 (12%) had Ca oxalate + uric acid stone, 10 (5%) had Ca phosphate + uric acid stone, and 9 patients (4%) had Ca oxalate + struvite stone. There was no relationship between sex or age of patient and the type of stone and the prevalence of each kind of stones was similar in both sexes.Discussion: Generally, this study indicated that the most popular type of kidney stone in our population is mixed type. The most frequent portion of mixed stones was made by Ca. But, the frequency of uric acid and strovite stones was less in this study comparing with other surveys; the reason may be as this type of stone is not appropriate to be treated by lithotripsy and they usually are managed by medical treatment.        

کلیدواژه‌ها [English]

  • Renal stone
  • Ca oxalate stone
  • Ca phosphate stone
  • Uric acid stone
  • Struvite stone

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مجله دانشکده پزشکی اصفهان
دوره 28، شماره 122 - شماره پیاپی 122
بهمن و اسفند 1389
صفحه 1781-1791

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  • تاریخ دریافت: 08 فروردین 1390
  • تاریخ بازنگری: 05 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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