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尿酸尿路结石的临床研究

Clinical study of uric acid urolithiasis.

作者信息

Chou Yii-Her, Li Wei-Ming, Li Ching-Chia, Huang Shu-Pin, Liu Chia-Chu, Wu Wen-Jeng, Hsiao Hsi-Lin, Chang Tu-Hao, Juan Yung-Shun, Su Chien-Yu, Hsu Hsing, Huang Chun-Hsiung

机构信息

Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.

出版信息

Kaohsiung J Med Sci. 2007 Jun;23(6):298-301. doi: 10.1016/S1607-551X(09)70412-7.

Abstract

Uric acid urolithiasis develops from various causes. To investigate the clinical and biochemical presentation of patients with uric acid urolithiasis, a retrospective study was designed. A total of 46 cases were enrolled between January 2004 and December 2005. The compositions of the stones were analyzed by infrared spectrophotometry. There were 39 males (84.8%) and seven females (15.2%), with a mean age of 61.5 +/- 10.6 years and mean body mass index (BMI) of 26.7 +/- 3.1 kg/m2. The stone location was kidney in 10 (21.7%), ureter in 22 (41.8%), and bladder in 14 (30.5%). Multiple stones were diagnosed in 36 patients (78.3%). Pre-existing comorbidities included diabetes mellitus in 11 patients (23.9%), hypertension in 23 (50%), gout in 13 (28.2%), and benign prostatic hyperplasia in 14 (30.4%). Mean serum creatinine and uric acid was 1.6 +/- 0.6 mg/dL and 7.6 +/- 1.8 mg/dL, respectively. There were 27 patients (58%) with creatinine > 1.4 mg/dL. The mean urinary pH was 5.42 +/- 0.46. Patients with uric acid urolithiasis were predominantly male, older, with higher BMI, multiple stone presentation, with lower urinary pH, and hyperuricemia. Exacerbation of the renal function should also be of concern because of the high proportion of patients with renal insufficiency diagnosed in this study.

摘要

尿酸结石的形成有多种原因。为了研究尿酸结石患者的临床和生化表现,设计了一项回顾性研究。2004年1月至2005年12月期间共纳入46例患者。通过红外分光光度法分析结石成分。其中男性39例(84.8%),女性7例(15.2%),平均年龄61.5±10.6岁,平均体重指数(BMI)为26.7±3.1kg/m²。结石位于肾脏10例(21.7%),输尿管22例(41.8%),膀胱14例(30.5%)。36例患者(78.3%)诊断为多发结石。既往合并症包括糖尿病11例(23.9%),高血压23例(50%),痛风13例(28.2%),良性前列腺增生14例(30.4%)。平均血清肌酐和尿酸分别为1.6±0.6mg/dL和7.6±1.8mg/dL。27例患者(58%)肌酐>1.4mg/dL。平均尿液pH值为5.42±0.46。尿酸结石患者以男性为主,年龄较大,BMI较高,多发结石,尿液pH值较低,且有高尿酸血症。由于本研究中诊断为肾功能不全的患者比例较高,肾功能恶化也应引起关注。

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本文引用的文献

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Novel insights into the pathogenesis of uric acid nephrolithiasis.对尿酸肾结石发病机制的新见解。
Curr Opin Nephrol Hypertens. 2004 Mar;13(2):181-9. doi: 10.1097/00041552-200403000-00006.
7
A complementary approach to urolithiasis prevention.一种预防尿石症的补充方法。
World J Urol. 2002 Nov;20(5):294-301. doi: 10.1007/s00345-002-0294-z. Epub 2002 Oct 17.
8
Uric acid nephrolithiasis: current concepts and controversies.尿酸肾结石:当前概念与争议
J Urol. 2002 Oct;168(4 Pt 1):1307-14. doi: 10.1016/S0022-5347(05)64439-4.
10
Biochemical profile of idiopathic uric acid nephrolithiasis.特发性尿酸肾结石的生化特征
Kidney Int. 2001 Aug;60(2):757-61. doi: 10.1046/j.1523-1755.2001.060002757.x.

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