Evaluation of possible predictive variables for the outcome of shock wave lithotripsy of renal stones.
Evaluation of possible predictive variables for the outcome of shock wave lithotripsy of renal stones.
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DOI：
10.4111/kju.2010.51.10.713
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发表时间：
2010-10
期刊：
影响因子：
--
通讯作者：
Chung JY
中科院分区：
文献类型：
--
作者：
Park YI;Yu JH;Sung LH;Noh CH;Chung JY
本研究的目的是评估单一中心冲击波碎石术(SWL)治疗肾结石预后的可能预测变量。在2008年3月至2010年3月期间，对115名因孤立性肾结石而接受SWL治疗的患者进行了回顾性研究。复习患者的特点和结石的大小、位置、皮肤到结石的距离(SSD)和Hounsfield单位(HU)。用Logistic回归分析评价可能的预测因素对结石崩解的影响。生成受试者操作员特征(ROC)曲线以比较变量的预测能力。79例患者(68.7%)获得成功，36例(31.3%)结石残留。结石的平均大小和HU分别为675.29±254.34和1075.00±290.41，差异有统计学意义(P<0.001)。在未调整的模型中，年龄、结石大小和结石密度是显著的预测因素。在简化模型中，结石密度和大小是SWL预后的显著预测因素。结石密度和大小的ROC曲线下面积显著高于其他参数，但结石密度和大小之间的面积无显著差异(结石密度：0.874，结石大小：0.827，P=0.388)。对于直径小于2.0厘米的肾结石，结石密度和大小是SWL结果的重要预测因素。在决定肾结石的治疗时，应考虑HU和结石大小。
The aim of this study was to evaluate possible predictive variables for the outcome of shock wave lithotripsy (SWL) of renal stones in a single center. Between March 2008 and March 2010, a retrospective review was performed of 115 patients who underwent SWL for solitary renal stones. The patients' characteristics and stone size, location, skin-to-stone distance (SSD), and Hounsfield units (HU) of stone were reviewed. The impact of the possible predictors on the disintegration of the stones was evaluated by logistic regression analysis. Receiver operator characteristic (ROC) curves were generated to compare the predictive powers of the variables. Seventy-nine patients (68.7%) had successful outcomes, whereas 36 patients (31.3%) had residual stones. Significant differences were found in the mean size and mean HU of the stones (size: 8.34±3.58 mm vs. 13.57±5.41 mm, p<0.001; HU: 675.29±254.34 vs. 1,075.00±290.41, p<0.001). In the unadjusted model, age, stone size, and stone density were significant predictors. In the reduced model, stone density and size were significant predictors for the outcome of SWL. The area under the ROC curve (AUC) was significantly higher for stone density and size than for the other parameters, but the AUC between stone density and size did not differ significantly (stone density: 0.874, stone size: 0.827, p=0.388). Stone density and size were significant predictors of the outcome of SWL for renal stones less than 2.0 cm in diameter. We should consider HU and stone size when making decisions on the treatment of renal stones.