Department of Urology, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, China.
Translational Research Laboratory for Urology, the Key Laboratory of Ningbo City, Ningbo First Hospital, The Affiliated Hospital of Ningbo University, Ningbo, China.
Postgrad Med J. 2018 Aug;94(1114):458-462. doi: 10.1136/postgradmedj-2017-135332. Epub 2018 Jul 12.
Uric acid stones account for 10%-15% of all urinary stones. Changes in dietary habits, environment or both can result in the increase of uric acid stones. The formation of uric acid stones is related to hyperuricosuria, low urinary volume and persistently low urinary pH. Diabetes and obesity also significantly increase the risk of stone formation. Dual-energy CT provides a convenient and reliable method for diagnosis. Stone composition analysis and 24-hour urine metabolic evaluations should be considered for further evaluation. Most small uric acid stones (diameter <2 cm) can be treated by pharmacotherapy or extracorporeal shock wave lithotripsy. However, ureteroscopy and other minimally invasive procedures should be reserved for larger stones (diameter ≥2 cm), or patients with concomitant urinary tract obstruction and/or infections. Additionally, adjustment of potential pathophysiologic defects by pharmacotherapy and dietary modification is strongly recommended for the prevention of uric stone recurrence.
尿酸结石占所有尿路结石的 10%-15%。饮食习惯、环境或两者的变化都可能导致尿酸结石的增加。尿酸结石的形成与高尿酸血症、尿量减少和持续低尿 pH 值有关。糖尿病和肥胖也显著增加了结石形成的风险。双能 CT 提供了一种方便可靠的诊断方法。应考虑结石成分分析和 24 小时尿液代谢评估以进行进一步评估。大多数小的尿酸结石（直径<2cm）可以通过药物治疗或体外冲击波碎石术治疗。然而，对于较大的结石（直径≥2cm）或伴有尿路梗阻和/或感染的患者，应保留输尿管镜检查和其他微创程序。此外，强烈建议通过药物治疗和饮食调整来纠正潜在的病理生理缺陷，以预防尿酸结石复发。
