Wall I, Tiselius H G
Department of Urology, University Hospital, Linköping, Sweden.
Urol Int. 1990;45(6):336-41. doi: 10.1159/000281732.
The effects of ammonium chloride, methenamine hippurate and ascorbic acid on urinary pH was studied in 14 normal subjects. A statistically significant reduction of urinary pH was recorded with ammonium chloride in daily doses of 1.5 and 3 g, but not with 2 g of methenamine hippurate or 1.8 g of ascorbic acid. Long-term treatment with ammonium chloride in doses between 1.5 and 3 g was given to 11 patients in order to reduce the risk of new stone formation or growth of fragments remaining after disintegration of infected renal stones. Biochemical stone analyses showed struvite in 9 of the treated stones, and urine cultures verified the presence of urease-producing bacteria in 10 patients. Apart from ammonium chloride, the patients were treated with antibiotics, in 4 patients continuously and in the others during periods from 2 to 34 months. The patients were followed for an average period of 32 months. No adverse reactions were recorded with the dosage used. Initially, 6 patients were stone-free, whereas 5 had residual stone fragments with a largest diameter ranging from 4 to 20 mm. At follow-up, 2 patients were still stone-free, and of 5 patients with residual fragments 1 showed stable disease and 3 an improved stone situation. In 5 patients, 3 of whom had residual stone fragments, antibiotic treatment had been interrupted without infectious relapse.(ABSTRACT TRUNCATED AT 250 WORDS)
在14名正常受试者中研究了氯化铵、马尿酸乌洛托品和维生素C对尿液pH值的影响。每日剂量为1.5克和3克的氯化铵可使尿液pH值显著降低，但2克马尿酸乌洛托品或1.8克维生素C则不会。为降低感染性肾结石分解后新结石形成或残留碎片生长的风险，对11名患者进行了剂量在1.5至3克之间的氯化铵长期治疗。结石生化分析显示，9颗治疗后的结石为鸟粪石，尿液培养证实10名患者存在产脲酶细菌。除氯化铵外，患者还接受了抗生素治疗，4名患者持续使用，其他患者使用时间为2至34个月。对患者平均随访32个月。所用剂量未记录到不良反应。最初，6名患者无结石，而5名患者有残留结石碎片，最大直径为4至20毫米。随访时，2名患者仍无结石，5名有残留碎片的患者中，1名病情稳定，3名结石情况有所改善。5名患者中，3名有残留结石碎片，抗生素治疗中断后未出现感染复发。（摘要截断于250字）
