Koide T, Yoshioka T, Yamaguchi S, Utsunomiya M, Sonoda T
Department of Urology, Osaka University School of Medicine, Japan.
J Urol. 1992 Jan;147(1):112-4. doi: 10.1016/s0022-5347(17)37150-1.
Simple mechanical disintegration of cystine calculi by extracorporeal shock wave lithotripsy and/or percutaneous nephrolithotomy is being performed widely around the world. However, it cannot be denied that the cystine calculus is one of the most difficult stones for mechanical disintegration. We previously reported the oral medical chemolysis of cystine calculi in 1982 and a third of the patients became stone-free. In another third of the patients the cystine component was replaced by apatite during the medical treatment and apatite stones formed in this manner are easily disintegrated. In view of the complications of mechanical disintegration, oral medical treatment for chemolysis should be recommended before simple destruction of cystine calculi.
世界各地都在广泛开展通过体外冲击波碎石术和/或经皮肾镜取石术对胱氨酸结石进行简单的机械破碎。然而，不可否认的是，胱氨酸结石是最难进行机械破碎的结石之一。我们曾在1982年报道了胱氨酸结石的口服药物化学溶解，三分之一的患者结石消失。在另外三分之一的患者中，胱氨酸成分在药物治疗期间被磷灰石替代，以这种方式形成的磷灰石结石很容易破碎。鉴于机械破碎的并发症，在单纯破坏胱氨酸结石之前，应推荐采用口服药物进行化学溶解治疗。
