1 812例唾液腺结石患者的人口学特征和临床特点

doi:10.19723/j.issn.1671-167X.2026.01.020

摘要/Abstract

摘要：

目的: 基于较大样本量及完善的临床与影像学资料，分析唾液腺结石病的人口学特征和临床发病特点。方法: 回顾性收集2020年1月至2024年12月于北京大学口腔医院唾液腺内镜中心就诊的唾液腺结石患者的临床及影像资料，统计患者的性别、年龄、病程及受累腺体，测量结石的数目、大小、位置及长短径之比，分析唾液腺结石病的人群特征、临床与影像学特点。结果: 共收集1 812例唾液腺结石患者，男性855例，女性957例，年龄4~97岁，平均年龄(39.0±15.0)岁，中位病程6.0个月。结石多累及单侧腺体(98.4%)，多为单发(64.3%)，平均直径(6.5±4.6) mm。本组病例包括下颌下腺结石1 541例(85.0%)，腮腺结石267例(14.7%)，其余4例患者的下颌下腺及腮腺均受累。下颌下腺结石多位于腺外主导管(50.2%)，其次为腺门部(41.5%)，仅少数位于腺内(8.2%)；腮腺结石大部分位于腺外主导管(75.2%)。下颌下腺结石的平均直径显著大于腮腺结石[(6.9±4.8) mm vs. (4.5±2.5) mm]，下颌下腺结石患者的平均年龄显著低于腮腺结石患者[(38.0±15.0)岁vs. (48.0±16.0)岁]。腮腺结石的复发率(3.4%)和下颌下腺结石的复发率(2.1%)都较低，复发间隔2个月至10年不等，平均(33.8±31.4)个月。本组病例中，21例(1.2%)患者的结石来源于异物钙化，包括9例下颌下腺结石和12例腮腺结石患者。结论: 唾液腺结石病好发于中年人群，无明显的性别差异，绝大多数为单侧腺体受累，单发结石较多见；下颌下腺结石与腮腺结石在好发部位、大小、结石形状(长宽比)及患者年龄等方面均存在明显差异；唾液腺结石的复发率较低，少数结石由异物钙化引起；这些发病特点，可为阐明唾液腺结石病的发病机制及优化诊疗策略提供依据。

关键词: 唾液腺结石, 腮腺, 下颌下腺, 影像学表现

Abstract:

Objective: To analyze the demographic and clinical features of sialolithiasis based on a large sample size. Methods: Clinical and imaging data of patients with sialolithiasis treated at the Sialendoscopy Center of Peking University School and Hospital of Stomatology from January 2020 to December 2024 were retrospectively collected. Patient demographics, disease duration, and affected glands were recorded. Moreover, the number, size, location, and long-to-short diameter ratio of the stones were mea-sured. Results: A total of 1 812 patients with salivary gland stones were collected, including 855 males and 957 females. The age range was 4 to 97 years [mean: (39.0±15.0) years] with a median disease duration of 6.0 months (interquartile range: 1.0-24.0). Most stones involved unilateral glands (98.4%), and 64.2% of the affected glands had a single stone. The stone size averaged at a diameter of (6.5±4.6) mm. The cases included 1 541 cases with submandibular gland (SMG) stones (85.0%), 267 cases with parotid gland (PG) stones (14.7%), and 4 cases affecting both SMG and PG. The SMG stones were mostly located in the extra-glandular main duct (50.2%), followed by the hilum (41.5%), and only 8.2% of them were in the intra-glandular area. The majority of PG stones (75.2%) were in the extra-glandular main duct. The average diameter of SMG stones was significantly larger than that of PG stones [(6.9±4.8) mm vs. (4.5±2.5) mm]. The average age of SMG patients was younger than that of PG patients [(38.0±15.0) years vs. (48.0±16.0) years]. There was no significant difference in recurrence rate between PG and SMG stones (3.4% vs. 2.1%). The recurrence intervals ranged from 2 months to 10 years, with an average of (33.8±31.4) months. In 21 patients (1.2%), the stones originated from foreign body calcification, which accounted for 0.6% (9/1 541) of SMG cases and 4.5% (12/267) of PG cases. Conclusion: Among the cases analyzed, sialolithiasis was the most common in middle-aged individuals, with no significant gender difference. Unilateral gland involvement was the most frequent, and 2/3 of the cases had a single stone. Significant differences were observed in the location, size, and patient age between SMG and PG stones. The recurrence rate of sialolithiasis was relatively low. Stones originated from foreign body calcification was occasionally seen. Understanding of these demographic and clinical characteristics provided a basis for clarifying the pathogenesis of sialolithiasis and optimizing the diagnostic and therapeutic strategies.

Key words: Salivary gland calculi, Parotid gland, Submandibular gland, Imaging characteristics

中图分类号:

R781.75

杨雨婷, 屈留洋, 郑丹妮, 凌晓彤, 许晓韵, 柳登高. 1 812例唾液腺结石患者的人口学特征和临床特点[J]. 北京大学学报（医学版）, 2026, 58(1): 153-159.

Yuting YANG, Liuyang QU, Danni ZHENG, Xiaotong LING, Xiaoyun XU, Denggao LIU. Demographic characteristic and clinical features in 1 812 patients with salivary gland stones[J]. Journal of Peking University (Health Sciences), 2026, 58(1): 153-159.

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Items	Total (n=1 808)^a	Type of affected glands		P value
Items	Total (n=1 808)^a	SMG	PG	P value
Number	1 808	1 541	267
Gender, n (%)				0.628
Male	854 (47.2)	732 (47.5)	122 (45.7)
Female	954 (52.8)	809 (52.5)	145 (54.3)
Age/years, $\bar x \pm s$	39.0±15.0	38.0±15.0	48.0±16.0	＜0.001
Duration of symptoms/month, M (P₂₅, P₇₅)	6.0 (1.0, 24.0)	6.0 (1.0, 24.0)	4.3 (1.0, 24.0)	0.302
Unilateral/Bilateral, n (%)				0.327
Left	844 (46.7)	724 (47.0)	120 (44.9)
Right	935 (51.7)	795 (51.6)	140 (52.4)
Bilateral	29 (1.6)	22 (1.4)	7 (2.6)
Quantity, n (%)				0.062
Single	1 162 (64.3)	974 (63.2)	188 (70.4)
Multiple	621 (34.3)	545 (35.4)	76 (28.4)
Recurrent	25 (1.4)	22 (1.4)	3 (1.1)
Location, n (%)				＜0.001
Anterior duct	581 (32.1)	460 (29.8)	121 (45.3)
Mid duct	394 (21.8)	315 (20.4)	79 (29.6)
Glandular hilum	669 (37.0)	639 (41.5)	30 (11.2)
Intraparenchymal	164 (9.1)	127 (8.2)	37 (13.9)
Mean maximum diameter/mm, $\bar x \pm s$	6.5±4.6	6.9±4.8	4.5±2.5	＜0.001
Long-to-short diameter ratio, $\bar x \pm s$	1.6±1.0	1.6±0.9	1.7±1.1	0.007

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