Lingeman J, Kahnoski R, Mardis H, Goldfarb D S, Grasso M, Lacy S, Scheinman S J, Asplin J R, Parks J H, Coe F L
Renal Section, University of Chicago, Illinois, USA.
J Urol. 1999 Apr;161(4):1077-81.
In general high urine supersaturation with respect to calcium oxalate, calcium phosphate or uric acid is associated with that phase in stones. We explore the exceptions when supersaturation is high and a corresponding solid phase is absent (type 1), and when the solid phase is present but supersaturation is absent or low (type 2).
Urine supersaturation values for calcium oxalate, calcium phosphate and uric acid, and other accepted stone risk factors were measured in 538 patients at a research clinic and 178 at stone prevention sites in a network served by a single laboratory.
Of the patients 14% lacked high supersaturation for the main stone constituent (type 2 structural divergence) because of high urine volume and low calcium excretion, perhaps from changes in diet and fluid intake prompted by stones. Higher calcium excretion and low urine volume caused type 1 divergences, which posed no clinical concern.
Type 1 divergence appears to represent a condition of low urine volume which raises supersaturation in general. Almost all of these patients are calcium oxalate stone formers with the expected high supersaturation with calcium oxalate as well as high uric acid and calcium phosphate supersaturations without either phase in stones. Type 2 divergence appears to represent an increase in urine volume and decrease in urine calcium excretion between stone formation and urine testing.
一般来说，尿液中草酸钙、磷酸钙或尿酸的高饱和度与结石的该阶段相关。我们探讨了高饱和度时相应固相不存在（1型）以及固相存在但饱和度不存在或低（2型）的例外情况。
在一家研究诊所对538名患者以及由单个实验室服务的网络中结石预防站点的178名患者测量了草酸钙、磷酸钙和尿酸的尿液饱和度值以及其他公认的结石风险因素。
14%的患者因尿量高和钙排泄低而缺乏主要结石成分的高饱和度（2型结构差异），这可能是由于结石促使饮食和液体摄入量发生变化所致。较高的钙排泄和低尿量导致1型差异，这在临床上并无大碍。
1型差异似乎代表尿量低的一种情况，总体上会提高饱和度。几乎所有这些患者都是草酸钙结石形成者，预期草酸钙饱和度高，同时尿酸和磷酸钙饱和度也高，但结石中没有任何一个相。2型差异似乎代表结石形成与尿液检测之间尿量增加和尿钙排泄减少。
