目的:探讨血脂异常与上尿路结石发病风险的相关性.方法:回顾性分析2013年1月～2015年10月于青大附院泌尿外科住院的700例(男415例,女285例)上尿路结石患者的临床资料,按照年龄和性别配对,以1∶2配比选取同时期在青大附院健康查体中心进行体检的1400位健康人作为对照组.收集两组人群年龄、性别、身高、体重、高血压病史、糖尿病史和血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-c)、低密度脂蛋白(LDL-c)、尿酸(UA)等数据.应用Cox比例风险回归模型分析血脂异常与上尿路结石发病风险的相关性.结果:结石组中超重、高血压、糖尿病、尿酸水平及各血脂成分所占比例均显著高于对照组(P＜0.05).在调整了超重、高血压、糖尿病、UA水平等因素后,Cox比例风险回归分析表明低HDL-c血症(HR=2.039,95％CI:1.583～2.627,P＜0.05)和高LDL-c血症(HR:1.556,95％CI:1.205～2.009,P＜0.05)与上尿路结石的发生显著相关.结论:上尿路结石患者中血脂异常的比例显著高于对照组,尿路结石的发生与血脂异常显著相关,低HDL-c血症和高LDL-c血症可能是上尿路结石患者发病的独立危险因素.

Objective To investigate the feasibility of a rat carotid atherosclerosis model induced by artery clamping with high-cholesterol diet and vitamin D3.Methods Twenty Wista rats were randomly divided into either a general diet group (n =5) or a high cholesterol diet group (n =15).After clamping the right common carotid arteries of the rats in the high cholesterol diet group,they were fed with high fat diet,and vitamin D3 (600 000 IU/kg) was injected intraperitoneally.The lipid levels of the general diet group and the high cholesterol diet group were detected at 6 and 12 weeks respectively.The bilateral cormmon carotid arteries were selected for preparing paraffin sections and were stained with HE staining.The pathological changes in blood vessels were observed.Results The levels of serum total cholesterol at 12 weeks (2.803 ± 1.307 mmol/L vs.1.513 ±0.281 mmol/L; P=0.017) and low-density lipoprotein cholesterol (0.660± 0.260 mmol/L vs.0.311 ±0.078 mmol/L; P =0.003) in the high-cholesterol diet group were significantly higher than those at 6 weeks.The histopathological examination showed that the common carotid artery intimas on the clamping sides were incomplete,the foam cell deposition was observed under intima,the atherosclerotic plaques or fibrous plaques were observed on the surface of cavity,inside the plaques contained necrotic tissue,and thrombosis was observed in the cavity.The common carotid artery intima-media thickness in the general diet group (n =5) at 12 weeks was 8.3 ± 1.1 μm.The sham-operated sides (n =20) and clamping sides (n =20) were 8.8 ± 0.7 μm and 97.4 ±25.7 μm,respectively.There were significant differences among the three groups (F =116.313,P=0.000).The clamping sides in the high-cholesterol diet group were significantly higher than the shamoperated sides in the high-cholesterol diet group (P=0.000) and the general diet group (P =0.000).Conclusions Common carotid artery clamping with high-cholesterol diet and vitamin D3 is a simple and feasible method for inducing a rat carotid atherosclerosis model.