Reusz G S, Dobos M, Byrd D, Sallay P, Miltényi M, Tulassay T
First Department of Paediatrics, Semmelweis University Medical School, Budapest, Hungary.
Pediatr Nephrol. 1995 Feb;9(1):39-44. doi: 10.1007/BF00858966.
We have established normal values for calcium/creatinine (Ca/Cr) and oxalate/creatinine (Ox/Cr) ratios in 25 infants (aged 1-7 days) and 391 children (aged 1 month to 14.5 years) and compared these with values obtained in 137 children with post-glomerular haematuria and 27 with nephrolithiasis. Oxalate was measured by ion chromatography. Nomograms of Marshall and Robertson were used to calculate urine saturation to calcium oxalate. The Ca/Cr ratio was normally distributed whereas the Ox/Cr ratio had a log-normal distribution. The molar ratio of Ca/Cr was the lowest in the first days of life and the highest between 7 month and 1.5 years (mean +/- SD = 0.39 +/- 0.28 mmol/mmol). Following a slight decrease it stabilised by the age of 6 years (0.34 +/- 0.19 mmol/mmol). The highest Ox/Cr values were measured during the 1st month of life [geometric mean 133 (range 61-280) mumol/mmol], followed by a gradual decrease until 11 years of age [mean 24 (range 6-82) mumol/mmol]. Thirty-six haematuric children had hypercalciuria (26%), 23 had absorptive hypercalciuria, 13 renal type. Children with absorptive hypercalciuria on a calcium-restricted diet had significantly higher oxalate excretion than those with renal hypercalciuria and the control group [38 (range 28-49) vs. 22 (range 16-29) and 23 (range 22-27) mumol/mol respectively, P < 0.01]. Calcium oxalate urine saturation of stone patients was higher than that of patients with haematuria and the normal population (1.18 +/- 0.05 vs. 1.06 +/- 0.03, P < 0.03 and 0.84 +/- 0.03, P < 0.001 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
我们已测定了25名婴儿(1至7日龄)和391名儿童(1月龄至14.5岁)的钙/肌酐(Ca/Cr)和草酸盐/肌酐(Ox/Cr)比值的正常范围,并将其与137名肾小球后血尿儿童和27名肾结石患儿的测定值进行比较。草酸盐通过离子色谱法测定。采用Marshall和Robertson列线图计算草酸钙的尿液饱和度。Ca/Cr比值呈正态分布,而Ox/Cr比值呈对数正态分布。Ca/Cr的摩尔比值在生命最初几天最低,在7个月至1.5岁之间最高(均值±标准差=0.39±0.28 mmol/mmol)。稍有下降后,到6岁时趋于稳定(0.34±0.19 mmol/mmol)。Ox/Cr的最高值在出生后第1个月测得[几何均值133(范围61至280)μmol/mmol],随后逐渐下降,直至11岁[均值24(范围6至82)μmol/mmol]。36名血尿儿童有高钙尿症(26%),23名有吸收性高钙尿症,13名有肾性高钙尿症。限制钙饮食的吸收性高钙尿症患儿的草酸盐排泄显著高于肾性高钙尿症患儿和对照组[分别为38(范围28至49)、22(范围16至29)和23(范围22至27)μmol/mol,P<0.01]。结石患者的草酸钙尿液饱和度高于血尿患者和正常人群(分别为1.18±0.05对1.06±0.03,P<0.03;以及0.84±0.03,P<0.001)。(摘要截选至250字)