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尿酸尿路结石的流行病学、病理生理学及管理:一项叙述性综述

Epidemiology, pathophysiology, and management of uric acid urolithiasis: A narrative review.

作者信息

Abou-Elela A

机构信息

Department Of Urology, Faculty Of Medicine, Cairo University, Kasr Al Ainy St., P.O. 11553, Cairo 11562, Egypt.

出版信息

J Adv Res. 2017 Sep;8(5):513-527. doi: 10.1016/j.jare.2017.04.005. Epub 2017 Apr 28.

Abstract

An in-depth comprehension of the epidemiology as well as pathophysiology of uric acid urolithiasis is important for the identification, treatment, and prophylaxis of calculi in these patients. Persistently low urinary pH, hyperuricosuria, and low urinary volume are the most important factors in pathogenesis of uric acid urolithiasis. Other various causes of calculus formation comprises of chronic diarrhea, renal hyperuricosuria, insulin resistance, primary gout, extra purine in the diet, neoplastic syndromes, and congenital hyperuricemia. Non-contrast-enhanced computed tomography is the radiologic modality of choice for early assessment of patients with renal colic. Excluding situations where there is acute obstruction, rising blood chemistry, severe infection, or unresolved pain, the initial management ought to be medical dissolution by oral chemolysis since this method has proved to be effective in most of the cases.

摘要

深入了解尿酸尿路结石的流行病学和病理生理学对于识别、治疗和预防这些患者的结石非常重要。持续低尿pH值、高尿酸尿症和低尿量是尿酸尿路结石发病机制中最重要的因素。结石形成的其他各种原因包括慢性腹泻、肾性高尿酸尿症、胰岛素抵抗、原发性痛风、饮食中额外的嘌呤、肿瘤综合征和先天性高尿酸血症。非增强计算机断层扫描是早期评估肾绞痛患者的首选影像学检查方法。除了存在急性梗阻、血生化指标升高、严重感染或疼痛未缓解的情况外,初始治疗应采用口服化学溶解进行药物溶石,因为这种方法在大多数情况下已被证明是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5840/5512151/d421991b1e62/fx1.jpg

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