Strauss A L, Coe F L, Parks J H
Arch Intern Med. 1982 Mar;142(3):504-7.
Of 859 consecutive patients with calcium renal stones, 182 had formed only one stone before entering our program. Ninety-three (51.1%) had idiopathic hypercalciuria or hyperuricosuria; 36 (19.8%) others had a systemic disorder producing stones. The remainder, 53 (29.1%) patients, had no metabolic disorder. The frequency of hypercalciuria was lower than among patients with multiple stones. Compared with recurrent stone formers, patients with single stones were older when they passed their stones, suffered higher rates of complication such as surgery, cystoscopy, and urinary tract infection, and had a lower frequency of idiopathic hypercalciuria. During treatment, 11% formed a new stone in an average follow-up period of three years, a relapse rate similar to that of multiple stone formers; however, those patients with single stones who did relapse formed new stones at lower rates than multiple stone formers. Compared with recurrent stone formers, patients with solitary stones were more often treated with diet alone. Since there were no substantial differences between solitary and recurrent stone disease, patients who have formed a single stone should be evaluated and they should be treated no differently from other patients with stone disease.
在859例连续性肾钙结石患者中，182例在进入我们的研究项目之前仅形成过一枚结石。其中93例（51.1%）患有特发性高钙尿症或高尿酸尿症；另外36例（19.8%）患有导致结石形成的全身性疾病。其余53例（29.1%）患者没有代谢紊乱。高钙尿症的发生率低于多发结石患者。与复发性结石形成者相比，单发结石患者排出结石时年龄更大，手术、膀胱镜检查和尿路感染等并发症的发生率更高，特发性高钙尿症的发生率更低。在治疗期间，在平均三年的随访期内，11%的患者形成了新结石，复发率与多发结石形成者相似；然而，那些复发的单发结石患者形成新结石的几率低于多发结石形成者。与复发性结石形成者相比，孤立性结石患者更多仅接受饮食治疗。由于孤立性结石病和复发性结石病之间没有实质性差异，因此对于已形成单发结石的患者应进行评估，并且他们的治疗方式应与其他结石病患者无异。
