Wasserstein A G, Stolley P D, Soper K A, Goldfarb S, Maislin G, Agus Z
Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia.
Miner Electrolyte Metab. 1987;13(2):85-95.
We compared epidemiological risk factors and urine excretion of calcium, phosphate, uric acid, urea nitrogen, sodium, potassium, and fluid volume in recurrent idiopathic calcium stone-formers and in a control group of age- and sex-matched normal volunteers. Stone-formers were less likely than normal subjects to have followed a low-calorie diet, but body weight did not differ between the two groups. Daily urine calcium excretion was a graded risk factor for stone formation throughout its range. Daily urine urea nitrogen and potassium excretion were lower in stone-formers than in controls, but excretion of uric acid, sodium, phosphate, and creatinine did not differ. However, there were positive associations between urine calcium excretion and the urine excretion of sodium, urea nitrogen, uric acid, phosphate, and creatinine in stone-formers; and these associations were significantly stronger than in normal subjects. We conclude that urine calcium excretion is a major risk factor for idiopathic calcium stone formation, but cannot confirm such a role for urine uric acid excretion. Total dietary protein intake may be lower in stone-formers than in controls. However, stone-formers may be more sensitive than normal subjects to the calciuric effects of protein and sodium. A strong association of urine calcium excretion with urine phosphate excretion in stone-formers is probably independent of dietary protein intake.
我们比较了复发性特发性钙结石患者与年龄和性别匹配的正常志愿者对照组的流行病学危险因素以及钙、磷酸盐、尿酸、尿素氮、钠、钾的尿排泄量和液体量。结石患者遵循低热量饮食的可能性低于正常受试者，但两组的体重没有差异。每日尿钙排泄量在其整个范围内都是结石形成的分级危险因素。结石患者的每日尿尿素氮和钾排泄量低于对照组，但尿酸、钠、磷酸盐和肌酐的排泄量没有差异。然而，结石患者的尿钙排泄量与钠、尿素氮、尿酸、磷酸盐和肌酐的尿排泄量之间存在正相关；并且这些相关性在结石患者中明显强于正常受试者。我们得出结论，尿钙排泄是特发性钙结石形成的主要危险因素，但不能证实尿酸排泄也有这样的作用。结石患者的总膳食蛋白质摄入量可能低于对照组。然而，结石患者可能比正常受试者对蛋白质和钠的促钙尿作用更敏感。结石患者尿钙排泄量与尿磷酸盐排泄量之间的强相关性可能与膳食蛋白质摄入量无关。
