Lonsdale K
Science. 1968 Mar 15;159(3820):1199-207. doi: 10.1126/science.159.3820.1199.
X-ray diffraction studies have shown that there are several different kinds of human urinary calculi, with different age, sex, period, and geographical distributions. Juvenile bladder stones are typically urate and oxalate in small boys in certain stone belts. They have disappeared in some areas, particularly in Britain, but are still common in Thailand. India. and Turkey. Their cause is unknown. Adult bladder stones, formerly common in elderly men, were largely of uric acid and were due to a faulty diet. Juvenile kidney stones are rare, except in Turkey where they are similar to juvenile bladder stones. Adult kidney stones are by far the most universally common, especially in technically developed communities. They are found in both sexes (equally at postmortem), and in the United States and in Czechoslovakia the average number of hospital entries for stones, relative to the whole population, is about 1 per 1000 per annum (increasing) although the incidence in different districts varies by 4 to 1 or more. Such stones are mainly calcium oxalates and calcium and MgNH(4) phosphates. The incidence among the administrative class is at least 20 times that among agricultural workers, relative to their numbers. Stones are reported also to be an occupational hazard for air pilots. It is probably that much more exercise and the drinking of more water to prevent kidney dehydration (spirits and coffee are not effective for this purpose) would lower the high rate of incidence. Moderate acidification would prevent phosphate supersaturation of the urine, but is not effective for oxalates. It seems certain that, once a suitable seed is formed, epitaxy is largely responsible for deposition from urines that would otherwise remain supersaturated until voided. This would explain the curioLls radial and layered texture of many stones. Laboratory experiments might suggest ways of preventing orientated overgrowth.
X射线衍射研究表明,存在几种不同类型的人体尿路结石,它们在年龄、性别、时期和地理分布上有所不同。青少年膀胱结石通常为尿酸盐和草酸盐结石,多见于某些结石高发地区的小男孩。在一些地区,尤其是英国,这类结石已经消失,但在泰国、印度和土耳其仍很常见。其病因不明。成人膀胱结石以前在老年男性中较为常见,主要为尿酸结石,病因是饮食不当。青少年肾结石很少见,不过在土耳其,青少年肾结石与青少年膀胱结石相似。成人肾结石是目前最为普遍的,尤其是在技术发达的社区。男女均可发病(尸检时发病率相同),在美国和捷克斯洛伐克,相对于总人口,因结石住院的平均人数约为每年每1000人中有1例(呈上升趋势),尽管不同地区的发病率相差可达4倍或更多。这类结石主要是草酸钙结石以及钙和磷酸镁铵结石。相对于农业工人的数量,行政阶层的发病率至少是他们的20倍。据报道,结石也是飞行员的职业危害。很可能进行更多的运动以及多喝水以防止肾脏脱水(酒精和咖啡对此无效)会降低高发病率。适度酸化可防止尿液中磷酸盐过饱和,但对草酸盐无效。似乎可以肯定的是,一旦形成合适的晶种,外延生长在很大程度上导致了尿液中物质的沉积,否则这些物质会一直处于过饱和状态直至排出体外。这可以解释许多结石奇特的放射状和层状结构。实验室实验可能会提出防止定向过度生长的方法。