Lien J, Keane P
J Urol. 1983 Feb;129(2):401-4. doi: 10.1016/s0022-5347(17)52126-6.
Fifty-two patients with idiopathic calcareous urolithiasis (ICU) were studied with an oral calcium loading test. Twenty-one subjects were normo-calciuric with no other detectable abnormalities (NDA). Of 31 patients with hypercalciuria, 16 had elevated fasting urinary calcium excretion (UCaE) (HFC), and 15 had normal UCaE (NFC). The fasting UCaE was significantly higher and the theoretical renal threshold for phosphate (TmPO4) was significantly lower in ICU patients as compared to 19 control individuals. The mean post oral calcium loading (Post Ca) UCaE rose significantly in hypercalciuric patients compared with control subjects; however, only 18/31 (58 per cent) had values above the normal range. There was no correlation between the fasting UCaE and either the immunoreactive parathyroid hormone (iPTH) or nephrogenous cAMP (ncAMP) in ICU patients. The fasting ncAMP was normal in all subjects with ICU and 7 of 52 subjects had elevated fasting iPTH values. When ranked according to the fasting UCaE value, ICU patients formed a continuum in which the NDA and HFC groups represented the extremes. It is concluded that the responses to oral Ca loading serve no useful role in the identification of an individual ICU patient either in terms of the pathogenetic subgroup or in the differentiation from normal controls.
对52例特发性含钙尿路结石（ICU）患者进行了口服钙负荷试验研究。21名受试者尿钙正常，无其他可检测到的异常（NDA）。在31例高钙尿症患者中，16例空腹尿钙排泄（UCaE）升高（HFC），15例UCaE正常（NFC）。与19名对照个体相比，ICU患者的空腹UCaE显著更高，而理论磷酸盐肾阈（TmPO4）显著更低。与对照受试者相比，高钙尿症患者口服钙负荷后（Post Ca）的平均UCaE显著升高；然而，只有18/31（58%）的值高于正常范围。ICU患者的空腹UCaE与免疫反应性甲状旁腺激素（iPTH）或肾源性环磷酸腺苷（ncAMP）之间均无相关性。所有ICU受试者的空腹ncAMP均正常，52名受试者中有7名空腹iPTH值升高。根据空腹UCaE值排序时，ICU患者形成一个连续体，其中NDA和HFC组代表两端。结论是，口服钙负荷试验的反应在确定个体ICU患者的致病亚组或与正常对照的区分方面均无有用作用。
