北海道オホーツク沿岸地域における尿路結石症の疫学的検討

Abstract

1997～2001年に当院で尿路結石症と診断された422名を対象に検討した.年間有病率(人口10万対)は, 上部尿路結石は男性では平均231.6名, 女性では128.8名で, 下部尿路結石では, 男性では平均26.1名, 女性では平均10.8名であった.初発再発例を合計すると, 上部尿路結石90.8%, 下部尿路結石9.2%であった.上部尿路結石の年齢階級別罹患率では好発年齢が男女共50歳代にピークが認められた.下部尿路結石の年齢階級別罹患率では男女とも60歳以上に多く認められた.のべ398例の上部尿路結石の治療法は, 経尿道的尿管砕石術施行例が63例で, 他院紹介による体外衝撃波砕石術施行例は45例であった.下部尿路結石における治療法は, 経尿道的砕石術が79.5%に施行されたが, 大きい膀胱結石には開腹術が選択された.結石分析では, 上部尿路結石では男女共にカルシウム含有結石が多く, 下部尿路結石においては男女とも感染結石が多かった

An epidemiological study of 422 stone-formers who visited our hospital from 1997 to 2001 was conducted. The mean annual prevalence and incidence of both upper and lower urinary tract stones were higher than what was found in a nationwide urolithiasis survey carried out in Japan in 1995. The incidence of upper and lower urinary tract stones was 90.8% and 9.2%, respectively. The frequency of lower urinary tract stones was higher than that found in the previously mentioned nationwide study. The male-to-female ratio of upper and lower urinary tract stones was 1.68:1 and 2.25:1, respectively. The frequency in females was higher in this study than that found in the nationwide survey. The peak age for incidence of upper urinary tract stones is 50s in males and females. In the treatment of upper urinary tract stones, ureteroscopic lithotripsy was carried out more often than shock wave lithotripsy (SWL), because our hospital had no SWL device. Many endoscopic lithotripsy procedures were performed to treat stones located in the lower urinary tract. Of the upper urinary tract stones 83.7% were composed of calcium, the incidence of uric acid stones was high (6.6%), whereas the incidence of infectious stones was low (1.9%). For lower urinary tract stones, the frequency of infectious stones was high (52.6%). In the present study, the epidemiological features were as follows: high annual prevalence and incidence, high frequency of lower urinary tract stones, high frequency in females, many endoscopic treatment procedures and high frequency of uric acid stones in the upper urinary tract.