Döhlemann C, Ellert A, Güntner M, Durner J, Gockerell N, Messmer E, Vogeser M
Dr. von Hauner'sches Kinderspital, Universitätskinderklinik, Lindwurmstraße 4, 80337 München, Deutschland.
Urologe A. 2011 Apr;50(4):466-76. doi: 10.1007/s00120-011-2505-y.
The old urinary calculi of the votive offerings in the pilgrimage church at Grafrath offer the possibility of analysing the components by infrared spectroscopy to give insights into factors that might influence their formation. A total of 166 specimens were taken from 139 objects (134 stones, 5 bones), in some stones from different layers.
Spectral analysis showed typical components for urinary calculi in 127 stones. These were compared with a control group of 98 urinary stones from carriers (77 male, 21 female) during 2007/2008 in Bavaria.
The percentage of occurrence of ammonium acid urate (NH(4)U) was high in the old stones (68.0%) versus the 2007/2008 group (1.0%). In uric acid (HS) there was no relevant difference between the two groups, whereas the occurrence of the oxalates whewellite (Whe) and weddellite (Wed) was much less in the old stones (Whe 18.1-69.4%, Wed 7.9-26.5 %). The phosphates differ in the components in favour of brushite in the old stones. The high occurrence of NH(4) in the old stones is comparable with (a) the old pre-1900 collection of Norwich (England), especially with the pre-1800 juvenile bladder stones, and (b) urinary stones in endemic areas of stone disease in children such as in North Thailand. Data about the Grafrath stone carriers (name, age, hometown) are not available but can indirectly be derived from the miracle books (1444-1728) of Grafrath with 12,131 reports; 1,165 had urologic disease of which 70% were children with urinary calculi coming from areas of Upper Bavaria and Swabia.
The finding of a high NH(4)U content indicates that this area might have been a stone belt for bladder stones in children. Under- or malnutrition with low protein and low fluid intake may be the aetiologic factor.
格拉夫拉特朝圣教堂中奉献物上的古老尿结石提供了通过红外光谱分析其成分的可能性，以便深入了解可能影响其形成的因素。总共从139件物品（134块石头，5块骨头）中采集了166个样本，有些石头取自不同层。
光谱分析显示127块石头中有尿结石的典型成分。将这些成分与2007/2008年巴伐利亚州98名结石患者（77名男性，21名女性）的尿结石对照组进行了比较。
与2007/2008年组（1.0%）相比，古老结石中尿酸铵（NH₄U）的出现百分比很高（68.0%）。在尿酸（HS）方面，两组之间没有显著差异，而古老结石中草酸钙石（Whe）和水草酸钙石（Wed）的出现率要低得多（Whe为18.1 - 69.4%，Wed为7.9 - 26.5%）。古老结石中的磷酸盐成分更倾向于透钙磷石。古老结石中高含量的NH₄与（a）英国诺维奇1900年前的古老藏品，特别是1800年前的儿童膀胱结石，以及（b）儿童结石病流行地区（如泰国北部）的尿结石情况相当。关于格拉夫拉特结石携带者（姓名、年龄、家乡）的数据无法获取，但可以从格拉夫拉特的奇迹书（1444 - 1728年）中的12131份报告中间接推导出来；其中1165例患有泌尿系统疾病，其中70%是来自上巴伐利亚州和施瓦本地区的患有尿结石的儿童。
高NH₄U含量的发现表明该地区可能曾是儿童膀胱结石的结石高发区。蛋白质和液体摄入量低的营养不良或营养不足可能是病因。
