Akinci M, Esen T, Koçak T, Ozsoy C, Tellaloğlu S
Department of Urology, Medical Faculty of Istanbul, Turkey.
Eur Urol. 1991;19(3):240-3. doi: 10.1159/000473629.
Between October 1988 and March 1990, 173 urinary stone patients (average age 38.3 years) were evaluated metabolically, especially with regard to urinary magnesium, pyrophosphate (Ppi) citrate and glycosaminoglycans (GAG). 25 healthy subjects served as controls. Inhibitory deficiency was found to be the most frequent causal factor in our series, with an incidence of 48.7% in first-time stone formers and 51.08% in recurrent urolithiasis (p less than 0.1). Deficient citrate levels were present in 46.56%, hypomagnesiuria in 24.4%, hypopyrophosphaturia in 10.7% and deficient GAG in 2.7% of the patients. Deficient urinary Ppi was seen in only 2.7% of the stone formers as the only metabolic defect, while deficient GAG was never the only causal factor. All 4 inhibitors showed no correlation with age, sex, activity of stone disease, stone weight and burden. There were no statistically significant differences with controls. We think that routine metabolic evaluation must be performed both in recurrent patients and first-time stone formers and must include urinary citrate and Mg determinations in every case. Urinary Ppi should be determined in selected cases and GAG determinations are irrational.
1988年10月至1990年3月期间，对173例尿石症患者（平均年龄38.3岁）进行了代谢评估，尤其关注尿镁、焦磷酸盐（Ppi）、柠檬酸盐和糖胺聚糖（GAG）。25名健康受试者作为对照。在我们的研究系列中，抑制物缺乏被发现是最常见的致病因素，初发结石患者的发生率为48.7%，复发性尿路结石患者的发生率为51.08%（p<0.1）。46.56%的患者柠檬酸盐水平不足，24.4%的患者存在低镁尿症，10.7%的患者存在低焦磷酸盐尿症，2.7%的患者存在GAG缺乏。仅2.7%的结石形成者中可见尿Ppi缺乏作为唯一的代谢缺陷，而GAG缺乏从未是唯一的致病因素。所有4种抑制剂均与年龄、性别、结石疾病活动度、结石重量和负荷无关。与对照组相比无统计学显著差异。我们认为，复发性患者和初发结石患者均必须进行常规代谢评估，且每种情况均必须包括尿柠檬酸盐和镁的测定。应在选定病例中测定尿Ppi，而测定GAG是不合理的。
