尿路结石患者生化异常的筛查。

Screening for biochemical abnormalities in urolithiasis patients.

作者信息

Orakzai Nasir, Hanbury Damian C, Farrington Kenneth

机构信息

Department of Urology, Lister Hospital, Coreys Mill Lane, Stevenage, UK.

出版信息

J Ayub Med Coll Abbottabad. 2004 Apr-Jun;16(2):60-3.

PMID:15455621

Abstract

BACKGROUND

The significance of biochemical screening in stone formers has been a debated topic. This study was conducted to investigate the frequency of biochemical abnormalities in our urolithiasis patients and to compare the abnormality between the first time and recurrent stone formers so that this information would help in assessing the value of biochemical screening in our practice.

METHODS

Over a twenty-one month period, new and recurrent stone disease patients had one random blood specimen and two random 24-hour urine collections analysed for biochemical abnormalities. Serum was checked for calcium, urate, phosphate and creatinine. The urines were measured for volumes, calcium, oxalate, urate, citrate, cystine and pH.

RESULTS

Out of total of 113 patients, 83 (73%) had some urinary or blood abnormality. Highest number of abnormalities were in urine. Low volume 33 (39.76%), hypercalciuria 33 (39.76%) and hyperoxaluria 20 (24.1%) were the main urinary abnormalities. Elevated serum creatinine in 10 (12.05%) was commonest blood abnormality. Females had significantly higher frequencies of low urinary volume (48% vs 21%, p=0.001), hyperoxaluria (38% vs 11%, p=0.002) and hypocitraturia (37% vs 0%, p<0.001). There was no significant difference of abnormality rate between first time and recurrent stone formers.

CONCLUSION

A high frequency of urinary biochemical abnormality and equal abnormality frequencies among first time and recurrent stone formers highlights the significance of biochemical screening even in cases of initial stone presentation. We feel such diagnostic evaluation would help in providing precise treatment and efficient prophylaxis.

摘要

背景

结石形成者的生化筛查意义一直是个有争议的话题。本研究旨在调查我们尿路结石患者生化异常的发生率，并比较初发结石患者和复发性结石患者之间的异常情况，以便这些信息有助于评估我们临床实践中生化筛查的价值。

方法

在21个月的时间里，对新发病例和复发性结石病患者的一份随机血液样本以及两份随机的24小时尿液样本进行生化异常分析。检测血清中的钙、尿酸盐、磷酸盐和肌酐。测量尿液的体积、钙、草酸盐、尿酸盐、柠檬酸盐、胱氨酸和pH值。

结果

在总共113例患者中，83例（73%）存在一些尿液或血液异常。异常最多的是尿液。低尿量33例（39.76%）、高钙尿症33例（39.76%）和高草酸尿症20例（24.1%）是主要的尿液异常。血清肌酐升高10例（12.05%）是最常见的血液异常。女性低尿量（48%对21%，p = 0.001）、高草酸尿症（38%对11%，p = 0.002）和低枸橼酸盐尿症（37%对0%，p < 0.001）的发生率显著更高。初发结石患者和复发性结石患者之间的异常率没有显著差异。