Wall I, Tiselius H G, Larsson L
Department of Urology, Linköping University, Faculty of Health Sciences, Sweden.
Eur Urol. 1988;15(1-2):26-30. doi: 10.1159/000473388.
Experimental irrigation of 15 infectious renal stones with hemiacidrin resulted in complete dissolution of 11 stones within 5 days. Three of the undissolved stones had a calcium oxalate (CaOx) content of more than 10%. Stones containing calcium phosphate (CaP) and magnesium ammonium phosphate (MAP) and weighing less than 500 mg were most easily dissolved. Twenty-five stones placed in 10 ml of hemiacidrin resulted in complete dissolution of 13 and partial dissolution of 11. Even this experiment showed that the CaOx content was of importance for the outcome of hemiacidrin treatment. After treatment the MAP and CaP fractions had decreased and CaOx increased. In 36 clinical irrigations of residual concrements of known chemical composition, 5 resulted in total stone dissolution and 21 in a reduced stone volume, whereas the result was inconclusive in 3. Seven stones were not affected by the treatment, these stones were usually composed of CaP and CaOx. There was a good correlation between the dissolution test and the clinical response to hemiacidrin treatment. Based on these findings it is suggested that hemiacidrin might be a useful complement to the modern techniques of stone fragmentation such as extracorporeal shock wave lithotripsy and percutaneous surgery, at least for infectious stones with a CaOx content of less than 10%.
用半胱氨酸对15颗感染性肾结石进行实验性冲洗，结果11颗结石在5天内完全溶解。3颗未溶解的结石草酸钙（CaOx）含量超过10%。含磷酸钙（CaP）和磷酸镁铵（MAP）且重量小于500毫克的结石最易溶解。将25颗结石置于10毫升半胱氨酸中，13颗完全溶解，11颗部分溶解。即便如此，该实验仍表明CaOx含量对半胱氨酸治疗效果至关重要。治疗后，MAP和CaP组分减少，CaOx增加。在对已知化学成分的残余结石进行36次临床冲洗中，5次结石完全溶解，21次结石体积减小，3次结果不明确。7颗结石未受治疗影响，这些结石通常由CaP和CaOx组成。溶解试验与半胱氨酸治疗的临床反应之间存在良好相关性。基于这些发现，建议半胱氨酸可能是体外冲击波碎石术和经皮手术等现代结石破碎技术的有益补充，至少对于CaOx含量小于10%的感染性结石是如此。
