Dick W H, Lingeman J E, Preminger G M, Smith L H, Wilson D M, Shirrell W L
Department of Urology, Methodist Hospital of Indiana, Indianapolis.
J Urol. 1990 Feb;143(2):244-7. doi: 10.1016/s0022-5347(17)39923-8.
Nine women with laxative abuse and predominantly ammonium urate renal calculi underwent metabolic studies to identify common chemical abnormalities and determine pathophysiology. The 24-hour urine studies demonstrated marked decreases in volume (902 cm.3), sodium (28 mEq.), citrate (116 mg.) and potassium (21 mEq.). A significant elevation in ammonium urate supersaturation was found compared to control subjects when studied by the computer model EQUIL 2. Of the patients 7 had 1 or more urine specimens positive for phenolphthalein. Gastrointestinal loss of fluid and electrolytes allowed for chronic extracellular volume depletion. Intracellular acidosis was present as judged by low urinary citrate and potassium. The fact that the ion product for ammonium urate is increased significantly compared to controls reflects the stated pathophysiological changes. Laxative abuse should be suspected whenever a woman has an ammonium urate renal calculus in sterile urine.
对9名有泻药滥用史且主要患有尿酸铵肾结石的女性进行了代谢研究，以确定常见的化学异常并确定病理生理学。24小时尿液研究显示，尿量（902立方厘米）、钠（28毫当量）、柠檬酸盐（116毫克）和钾（21毫当量）显著减少。通过计算机模型EQUIL 2研究发现，与对照受试者相比，尿酸铵过饱和度显著升高。7名患者的1份或更多份尿液标本酚酞呈阳性。胃肠道液体和电解质流失导致慢性细胞外液量减少。根据低尿柠檬酸盐和钾判断存在细胞内酸中毒。与对照组相比，尿酸铵离子产物显著增加这一事实反映了上述病理生理变化。每当女性无菌尿液中出现尿酸铵肾结石时，应怀疑有泻药滥用情况。
