兵庫県但馬地区における上部尿路結石の頻度

Abstract

公立豊岡病院において1991～1993年の上部尿路結石患者について集計した. 1)年間有病率は人口10万あたり125人(1991年), 156人(1992年), 141人(1993年)で, 年齢別有病率(1991年～1993年平均)は60歳代が最も高く245人, ついで50歳代235人, 40歳代205人であった. 2)年間罹患率は84人(1991年), 113人(1992年), 94人(1993年)で, 50歳代が最も高く169人であった. 3)男女比は有病率で2.0:1, 罹患率で2.2:1であった.男女別の罹患率をみると50歳代, 40歳代の男性が最も高く200人以上であった. 4)結石除去の治療は殆どがESWLであり, 有病者の23.4%であった.結石自排の患者は23.1%で, ESWL施行患者の平均年齢は52.5歳, 自排結石患者の年齢は47.0歳であった. 5)結石成分では蓚酸カルシウムが最も多く76%を占め, ついで尿酸16.4%, リン酸マグネシウムアンモニウム, リン酸カルシウム炭酸塩5.6%であった

Toyooka Hospital is a central hospital in Tajima, a rural area in the northern part of Hyogo Prefecture. Because we possess the sole lithotripter in this area, almost all urolithiasis patients requiring treatment have been referred to our department. Based on the number of urolithiasis patients treated in our institution, we estimated the annual prevalence and incidence of upper urinary tract stones in the Tajima area. The mean annual prevalence of urolithiasis and incidence during the 1991-1993 period were 141 and 93 per 100, 000, respectively. The male to female ratio was 2.0 to 1 in prevalence and 2.2 to 1.0 in incidence. Prevalence was highest in the sixties (245) and fifties (235), followed by the forties (205), seventies (162) and thirties (160). The incidence was highest in the fifties (169), followed by the forties (147), sixties (145) and thirties (118). In consideration of sex, the incidence was highest in males in the fifties and the forties. Of the patients with upper urinary calculi, 23.1% were treated by extracorporeal shock wave lithotripsy, while in 23.8% stones passed spontaneously and 50.9% were followed up without treatment. On stone analysis, calcium oxalate and/or calcium phosphate was present in 75.6%, uric acid in 16.4%, struvite and/or carbonate apatite in 5.6% and cystine in 1.4%. In summary, the prevalence and incidence of upper urinary tract calculi in the Tajima area were considerably higher than those in the nationwide survey on urolithiasis in Japan conducted in 1985.