Zechner O, Pflüger H, Scheiber V
J Urol. 1982 Dec;128(6):1219-23. doi: 10.1016/s0022-5347(17)53432-1.
Of 264 patients with urolithiasis those with pure uric acid or urate stones were compared to those with other types of calculi for differences in epidemiologic factors and uric acid, calcium and phosphate metabolism. Patients with uric acid stones were predominantly older men. These patients had comparatively lower incomes and spent less money on food but consumed more alcohol. The urinary pH was lower than in the other groups. The absence of abnormally elevated serum uric acid levels and elevated 24-hour urinary uric acid excretion suggests this variety of uric acid lithiasis to be idiopathic in nature. This finding is supported by the results of standardized oral purine loading, which showed no post-loading differences in serum levels and revealed urinary concentrations in 12 patients with pure uric acid stones and 10 normal subjects. However, there is evidence to suggest that this condition may be a precursor of primary gout. Hereditary mechanisms are absent and the relapse rate is the same as in patients with other stones. Therefore, our results suggest the existence of an idiopathic variety of uric acid lithiasis that, at least in central Europe, occurs more frequently than previously assumed. The condition is not inherited, alcohol consumption is a major etiologic factor and there is no evidence of a causative role of abnormalities in purine metabolism.
在264例尿石症患者中，将纯尿酸或尿酸盐结石患者与其他类型结石患者进行比较，以分析流行病学因素以及尿酸、钙和磷代谢的差异。尿酸结石患者以老年男性为主。这些患者收入相对较低，在食物上花费较少，但饮酒较多。其尿液pH值低于其他组。血清尿酸水平未异常升高且24小时尿尿酸排泄未增加，提示这种类型的尿酸结石本质上是特发性的。标准化口服嘌呤负荷试验结果支持这一发现，该试验显示负荷后血清水平无差异，并显示了12例纯尿酸结石患者和10名正常受试者的尿浓度。然而，有证据表明这种情况可能是原发性痛风的先兆。不存在遗传机制，复发率与其他结石患者相同。因此，我们的结果表明存在一种特发性的尿酸结石，至少在中欧，其发生率比以前认为的更高。这种情况不是遗传性的，饮酒是主要病因，没有证据表明嘌呤代谢异常起致病作用。
