Sarig S
Miner Electrolyte Metab. 1987;13(4):251-6.
Hyperuricosuric patients may form uric acid kidney stones and mixed stones containing both calcium oxalate and uric acid. Some of these patients form pure calcium oxalate stones. Explanation of this syndrome was based on the plausibility of epitaxial growth of calcium oxalate on uric acid crystals acting as substrates. In spite of convincing crystallographic consideration, laboratory experiments did not demonstrate any growth of calcium oxalate on uric acid seeds. An amino acid evidently adsorbing on uric acid seeds and attracting calcium ions could act as a mediating agent, thus realizing the potential of the epitaxial growth of calcium oxalate on uric acid crystals. Administration of allopurinol to hyperuricosuric calcium oxalate stone formers reduced the level of uric acid, consequently preventing the creation of uric acid crystals in urine. It should have removed the direct cause for the formation of calcium oxalate stones. Though undoubtedly more effective than placebo, the therapy with allopurinol was not unequivocally successful. Combined therapy using allopurinol and other drugs which were proved to be beneficial for idiopathic calcium oxalate stone formers, seems to give improved results. The use of procedures for evaluating the effect of therapy on risk factors has been started to predict success in individual cases.
高尿酸尿症患者可能会形成尿酸肾结石以及同时含有草酸钙和尿酸的混合性结石。其中一些患者会形成单纯的草酸钙结石。对该综合征的解释基于草酸钙在作为底物的尿酸晶体上外延生长的合理性。尽管有令人信服的晶体学考量，但实验室实验并未证明草酸钙在尿酸晶种上有任何生长。一种明显吸附在尿酸晶种上并吸引钙离子的氨基酸可能充当介导剂，从而实现草酸钙在尿酸晶体上外延生长的可能性。对高尿酸尿症草酸钙结石形成者给予别嘌呤醇可降低尿酸水平，从而防止尿液中尿酸晶体的形成。这本应消除草酸钙结石形成的直接原因。尽管别嘌呤醇疗法无疑比安慰剂更有效，但并非绝对成功。使用别嘌呤醇与其他已被证明对特发性草酸钙结石形成者有益的药物进行联合治疗，似乎能取得更好的效果。已开始采用评估治疗对危险因素影响的程序来预测个别病例的治疗成功情况。
