肢端肥大症患者尿路结石的代谢因素。

Metabolic factors for urolithiasis in acromegalic patients.

Heilberg I P, Czepielewski M A, Ajzen H, Ramos O L, Schor N

Disciplina de Nefrologia, Escola Paulista de Medicina, São Paulo, Brasil.

Braz J Med Biol Res. 1991;24(7):687-96.

Abstract

Acromegaly is associated with metabolic disturbances of calcium and phosphorus which can also contribute to renal lithogenesis. 2. In order to characterize these disturbances more precisely, an oral calcium load test was performed on 14 active acromegalic patients. Serum and urinary levels of calcium, phosphorus, uric acid, creatinine and urinary cyclic AMP were determined. 3. Of the 14 patients, 5 (36%) presented hypercalciuria, 5 (36%) presented intestinal calcium hyperabsorption, and 6 (43%) had uric acid hyperexcretion. Two patients (14%) presented nephrolithiasis. 4. The medical records of 32 additional acromegalic patients with or without active disease were reviewed for a history of previous stones, which was observed in three cases (9.5%). 5. The present data suggest that nephrolithiasis occurs more frequently among acromegalic patients because of the underlying metabolic disturbances of calcium presented by this population.

摘要

肢端肥大症与钙和磷的代谢紊乱有关，这也可能导致肾结石形成。2. 为了更精确地描述这些紊乱，对14例活动期肢端肥大症患者进行了口服钙负荷试验。测定了血清和尿液中的钙、磷、尿酸、肌酐以及尿环磷酸腺苷水平。3. 14例患者中，5例（36%）出现高钙尿症，5例（36%）出现肠道钙吸收过多，6例（43%）出现尿酸排泄过多。2例患者（14%）患有肾结石。4. 回顾了另外32例有或无活动期疾病的肢端肥大症患者的病历，以了解既往结石病史，其中3例（9.5%）有该病史。5. 目前的数据表明，由于该人群存在潜在的钙代谢紊乱，肢端肥大症患者中肾结石的发生率更高。