结石患者24小时尿液测试应用:在初级保健机构开展的一项基于人群的研究
Pietro Manuel Ferraro1, Andrea Spasiano2, Giovanni Gambaro2
1Section of Nephrology, Department of Medicine, Università Degli Studi Di Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy. pietromanuel.ferraro@univr.it.
Journal of nephrology
|September 5, 2025
概括
意大利对24小时尿液测试的遵守率非常低. 增加科诊所显著提高了检测率,强调需要提高认识和转诊实践.
科学领域:
- 肝脏病学
- 泌尿外科
- 临床化学
背景情况:
- 结石的形成是由于石化物质和抑制剂的不平衡.
- 目前的指导方针建议在结石患者中进行24小时尿液采集,以评估风险和监测治疗.
- 这些指导方针的实践数据稀缺且过时.
研究的目的:
- 评估意大利患者遵守24小时尿液检测指南.
- 评估专家咨询 (科和泌尿器科) 对检测率的影响.
- 确定影响KSD管理的代谢测试的因素.
主要方法:
- 来自健康搜索数据库 (2013-2022) 的实验室测试数据的回顾性分析.
- 包括患有脏或尿路结石的成年患者.
- 用尿中的,氧酸盐和酸盐测量作为完全代谢测试的替代物.
主要成果:
- 在21,907名确诊患者中,只有4. 8%的患者接受了24小时尿液检测,其中0. 6%的患者获得了所有三个关键测量结果.
- 复发性结石患者的检测率略高 (6. 1%).
- 脏病检查增加了检查概率近六倍 (OR 6. 09),而泌尿器科检查显示增加较小 (OR 1.95). 在患有慢性病 (CKD) 的人群中,只有不到10%的患者去看科医生.
结论:
- 对于患有结石的患者,24小时尿液检测和脏病转诊的认识和利用率显著低.
- 这些诊断工具对于个性化治疗和识别尿路异常至关重要.
- 促进检测和专家转诊可以改善患者护理,减少石头复发和并发症.
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