Grases F, March J G, Conte A, Costa-Bauzá A
Department of Chemistry, Faculty of Sciences, University of Balearic Islands, Palma de Mallorca, Spain.
Eur Urol. 1993;24(3):381-6. doi: 10.1159/000474333.
In this paper a thorough study on the composition and structure of calcium oxalate monohydrate (COM) papillary calculi is presented. In 86.4% of these calculi, small amounts of phosphates were detected and generally located at the calculi core. This demonstrates the importance of phosphates as the heterogeneous nucleus of 'pure' COM calculi. Study of the main biochemical parameters of these patients showed that the most frequent biochemical alteration was associated with hypocitraturia (25%), whereas hypercalciuria and/or hyperoxaluria were detected in very few cases. With respect to the urinary pH values, 70% of the patients presented values lower than 6 and 30% higher than 6. These facts indicate that in a number of cases the formation of phosphates is not the result of persistent high urinary pH values, and the presence of occasional papillary microinfections must be suspected. It is clear that, by avoiding the formation of heterogeneous phosphate nuclei, 'pure' COM calculi would not develop, and consequently therapies for these individuals under these conditions must take this into account.
本文对一水草酸钙（COM）乳头结石的组成和结构进行了深入研究。在这些结石中，86.4%检测到少量磷酸盐，且通常位于结石核心。这证明了磷酸盐作为“纯”COM结石异质核的重要性。对这些患者主要生化参数的研究表明，最常见的生化改变与低枸橼酸尿症（25%）有关，而高钙尿症和/或高草酸尿症仅在极少数病例中检测到。关于尿液pH值，70%的患者pH值低于6，30%高于6。这些事实表明，在许多情况下，磷酸盐的形成并非持续高尿pH值的结果，必须怀疑存在偶发性乳头微感染。显然，通过避免异质磷酸盐核的形成，“纯”COM结石不会形成，因此在这些情况下对这些个体的治疗必须考虑到这一点。
