Resim Sefa, Ekerbicer Hasan Cetin, Kiran Gurkan, Kilinc Metin
Department of Urology, KSU Medical School, Kahramanmaras, Turkey.
Urol Res. 2006 Aug;34(4):244-8. doi: 10.1007/s00240-006-0051-7. Epub 2006 Apr 14.
We aimed to objectively determine changes in the various urinary parameters along with CaOx saturation level during pregnancy. The study included 15 pregnant women who had no known diseases and were taking no medication except prenatal supplements. Mean age of the patients was 26 years (range 20-30). In all of them, this study was carried out in each trimester and 3 months post partum. All participants were followed up, and blood and urine samples were obtained during the pregnancy and during 3 months post partum. All subjects collected 24-h urine samples. The pregnant women had hypercalciuria in all three trimesters. Except for the first trimester, urine calcium levels in all trimesters were significantly higher when compared with the post-partum period (P<0.01 for second trimester, P<0.05 for third trimester). Urine oxalate level in post-partum period was significantly higher than urine oxalate levels in each trimester (P<0.05). The urine citrate levels were similarly higher than normal levels in three trimesters. Urine citrate level of the post-partum period was in normal reference ranges. This difference was not statistically significant (P>0.05). We believe that hypercalciuria encountered at pregnancy is a reversible physiologic condition. Also, citrate and magnesium as urinary inhibitors increased in urine during gestation preventing stone formation. We think that long time periods are needed for hypercalciuria to be able to lead to the formation of urinary calculi in pregnant women (except women having a positive family history). Therefore, we think that the pregnancy alone does not predispose to a suitable condition for calculi.
我们旨在客观地确定孕期各种尿液参数以及草酸钙饱和度水平的变化。该研究纳入了15名无已知疾病且除产前补充剂外未服用任何药物的孕妇。患者的平均年龄为26岁（范围20 - 30岁）。对所有这些孕妇在孕期的每个阶段以及产后3个月进行了此项研究。对所有参与者进行了随访，并在孕期和产后3个月采集了血液和尿液样本。所有受试者均收集了24小时尿液样本。所有三个孕期的孕妇均有高钙尿症。除了孕早期外，与产后时期相比，所有孕期的尿钙水平均显著更高（孕中期P<0.01，孕晚期P<0.05）。产后时期的尿草酸盐水平显著高于各孕期的尿草酸盐水平（P<0.05）。三个孕期的尿柠檬酸盐水平同样高于正常水平。产后时期的尿柠檬酸盐水平处于正常参考范围内。这种差异无统计学意义（P>0.05）。我们认为孕期出现的高钙尿症是一种可逆的生理状况。此外，作为尿液抑制剂的柠檬酸盐和镁在孕期尿液中增加，可预防结石形成。我们认为高钙尿症需要很长时间才会导致孕妇（除有阳性家族史的女性外）形成尿路结石。因此，我们认为仅怀孕本身并不会导致结石形成的适宜条件。
