Vitale C, Tricerri A, Manganaro M, Bagnis C, Bruno M, Marangella M, Ramello A
Centro Calcolosi Renale, U.O. di Nefrologia e Dialisi, Ospedale Mauriziano Umberto I, Torino.
Minerva Urol Nefrol. 1999 Jun;51(2):71-4.
In this paper, the clinical and metabolic patterns of nephrolithiasis in different ages of adulthood are studied.
Eight-hundred patients observed at the Mauriziano Hospital between 1990 and 1995, were classified into 3 groups, on the basis of age at the onset of disease: A: 20 through 39 years; B: 40 through 59; C: 60 years and over.
Calcium-oxalate stones had a lower recurrence in C (19.1%) and B (31.5%) than in A (41.7%). Pure uric acid stones recurred in 18.9% of C, 16.7% of B and 4.3% of A. The prevalence of hypercalciuria was higher in A (50.3%) than in B (35.9%) and C (36%); so did hypocitraturia. Hyperuricuria was lower in A (5%, p < 0.05) than in B (9.4%) and C (10%). Low urine pH (< 5.5) was 13% in A, 21.3% in B, 38% in C. Prevalence of hyperoxaluria was about 14% in all groups. The whole prevalence of secondary forms of stone disease was 13% in A, 12% in B and 30% in C. Differences among groups were mainly due to prevalence of urological abnormalities and urinary tract infection. In patients without metabolic disturbances. urological abnormalities or urinary tract infections altogether, were 4.6% in A; 5.2% in B; 33% in C. Urological approach removed 8% of stones in A, 5.6% in B and 10.2% in C.
Higher morbidity in younger patients could be due to a lower prevalence of easier-passing uric acid stones. The higher occurrence of urological disturbances and struvite stones in the elderly could explain the higher morbidity in this group.
本文研究了成年不同年龄段肾结石的临床和代谢模式。
1990年至1995年在毛里齐亚诺医院观察的800例患者，根据发病年龄分为3组：A组：20至39岁；B组：40至59岁；C组：60岁及以上。
草酸钙结石在C组（19.1%）和B组（31.5%）的复发率低于A组（41.7%）。纯尿酸结石在C组的复发率为18.9%，B组为16.7%，A组为4.3%。高钙尿症的患病率在A组（50.3%）高于B组（35.9%）和C组（36%）；低枸橼酸尿症也是如此。高尿酸尿症在A组（5%，p<0.05）低于B组（9.4%）和C组（10%）。低尿pH值（<5.5）在A组为13%，B组为21.3%，C组为38%。所有组中高草酸尿症的患病率约为14%。继发性结石病的总体患病率在A组为13%，B组为12%，C组为30%。组间差异主要归因于泌尿系统异常和尿路感染的患病率。在没有代谢紊乱、泌尿系统异常或尿路感染的患者中，A组为4.6%；B组为5.2%；C组为33%。手术取出结石的比例在A组为8%，B组为5.6%，C组为10.2%。
年轻患者发病率较高可能是由于更容易排出的尿酸结石患病率较低。老年人泌尿系统疾病和鸟粪石结石的发生率较高，可以解释该组发病率较高的原因。
