Scholz D, Schwille P O
Arzneimittelforschung. 1980;30(11):1928-32.
In a one-year double-blind study, the efficacy of hydrochlorothiazide was tested in 51 out-patients with recurrent calcium lithiasis. In the group to which thiazide had been administered, urinary calcium was significantly and lastingly reduced (p < 0.001 in fasting and daily urine), in the placebo group, however, it remained unaltered. Total serum calcium was unspecifically raised in both groups (protein-bound fraction) since ionized and ultrafiltrable calcium remained unchanged and parameters for parathyroid gland function tended to be reduced. The daily oxalate excretion in the urine was reduced in both groups during treatment and most expressedly in the placebo group (p < 0.05), which indicates an influence of unspecific factors. Activity products of calcium oxalate and brushite were reduced in both groups almost equally within the metastable region. In each group, 6 patients spontaneously developed kidney stones while treated. Our data indicate that effective reduction of urinary calcium by means of hydrochlorothiazide without dietary sodium restriction is possible and that causes other than urinary calcium must account for stone formation under thiazide administration.
在一项为期一年的双盲研究中,对51名复发性钙结石门诊患者进行了氢氯噻嗪疗效测试。在服用噻嗪类药物的组中,尿钙显著且持续降低(空腹和每日尿液中p < 0.001),而在安慰剂组中,尿钙保持不变。两组总血清钙均非特异性升高(蛋白结合部分),因为离子化和可超滤钙保持不变,甲状旁腺功能参数趋于降低。治疗期间两组尿中草酸日排泄量均减少,安慰剂组最为明显(p < 0.05),这表明存在非特异性因素的影响。两组草酸钙和透钙磷石的活性产物在亚稳区内几乎同等程度降低。每组在治疗期间有6名患者自发形成肾结石。我们的数据表明,在不限制饮食钠摄入的情况下,通过氢氯噻嗪有效降低尿钙是可能的,并且在服用噻嗪类药物时,除尿钙外的其他因素必定是结石形成的原因。