Goldwasser B, Sarig S, Azoury R, Wax Y, Hirsch D, Perlberg S, Many M
J Urol. 1984 Nov;132(5):1008-11. doi: 10.1016/s0022-5347(17)49988-5.
Allopurinol and orthophosphates were used in the treatment of 25 hyperuricosuric calcium oxalate stone formers. Their urines were tested by the Discriminating Index method, which measures the potential of a urine to retard calcium oxalate precipitation in vitro. The tests were performed before any treatment was begun and about 10 days after the commencement of drug intake. An insignificant effect by allopurinol and a markedly significant effect of orthophosphates on Discriminating Index were found. In a few of the patients, allopurinol seemed to cause a decrease in the urine's potential to retard calcium oxalate precipitation. Therefore the effect of allopurinol in 11 hyperuricosuric patients with no history of calcium oxalate stone formation was tested. In 5 of the 11 patients, the urine's potential to retard calcium oxalate precipitation decreased to levels similar to those of calcium oxalate stone formers. The results of this study suggest that hyperuricosuric calcium oxalate stone formers suffer from the same yet-undefined etiology of stone formation as other calcium oxalate stone formers. The results also question the role of uric acid in calcium oxalate stone formation and the efficacy of allopurinol in preventing this disease. It is suggested that allopurinol may even be related to stone formation in some patients.
别嘌醇和正磷酸盐用于治疗25例高尿酸尿草酸钙结石患者。采用鉴别指数法检测他们的尿液，该方法可测量尿液在体外抑制草酸钙沉淀的能力。在开始任何治疗之前以及开始服药约10天后进行检测。发现别嘌醇的作用不显著，而正磷酸盐对鉴别指数有显著作用。在少数患者中，别嘌醇似乎导致尿液抑制草酸钙沉淀的能力下降。因此，对11例无草酸钙结石形成病史的高尿酸尿患者进行了别嘌醇的疗效测试。在11例患者中的5例中，尿液抑制草酸钙沉淀的能力下降到与草酸钙结石患者相似的水平。本研究结果表明，高尿酸尿草酸钙结石患者与其他草酸钙结石患者患有相同但尚未明确的结石形成病因。研究结果还对尿酸在草酸钙结石形成中的作用以及别嘌醇预防该病的疗效提出了质疑。有人认为，别嘌醇甚至可能与某些患者的结石形成有关。
