Cupisti A, Morelli E, Meola M, Cozza V, Parrucci M, Barsotti G
Istituto Clinica Medica I, Università di Pisa, Italy.
Nephron. 1996;73(4):569-72. doi: 10.1159/000189142.
The prevalence of arterial hypertension (HT) was investigated in 258 patients (171 m, 87 f, 22-68 years) with a history of primary stone disease. HT was detected in 64 patients (24.8%), with no difference between males (25.7%) and females (23.0%). The prevalence of HT by age was very similar to that of a general population, especially in the calcium stone group. The discriminant analysis demonstrated that the composition of stones, other than the age and body weight of the patients, were the main factors associated with HT. As far as the different kind of stone is concerned, the prevalence of HT was higher in patients with uric acid (17/37, 45.9%) and struvite stones (11/27, 40.7%) than in calcium stone formers (35/188, 18.6%) (chi 2 16.31, p < 0.001). The prevalence of hypercalciuria was higher in the calcium stone group than in uric acid or struvite stone patients (36.4 vs. 9.7 vs. 13.7%; chi 2 10.35, p < 0.01). Furthermore, the hypercalciuria showed a trend to be more prevalent in the untreated (47.0%) than in the treated (31.2%) hypertensives, or normotensives (35.1%). Uric acid stone formers were older, heavier and with higher triglycerides and uric acid plasma levels than calcium or struvite patients. Also the struvite stone formers were older than the calcium stone ones. Our data suggest that the prevalence of HT in kidney stone patients and particularly in calcium stone formers is similar to that of a general population. The role of hypercalciuria as the link for HT-urolithiasis association seems quite uncertain. Struvite and uric acid stone formers have higher risk for HT than calcium stone formers, probably due to the old age or to the associated metabolic abnormalities.
对258例有原发性结石病病史的患者(171例男性,87例女性,年龄22 - 68岁)进行了动脉高血压(HT)患病率的调查。64例患者(24.8%)检测出患有HT,男性(25.7%)和女性(23.0%)之间无差异。HT按年龄的患病率与普通人群非常相似,尤其是在钙结石组。判别分析表明,除患者年龄和体重外,结石成分是与HT相关的主要因素。就不同类型的结石而言,尿酸结石患者(17/37,45.9%)和磷酸铵镁结石患者(11/27,40.7%)的HT患病率高于钙结石形成者(35/188,18.6%)(卡方值16.31,p < 0.001)。钙结石组高钙尿症的患病率高于尿酸或磷酸铵镁结石患者(36.4%对9.7%对13.7%;卡方值10.35,p < 0.01)。此外,高钙尿症在未治疗的高血压患者(47.0%)中比治疗过的高血压患者(31.2%)或血压正常者(35.1%)中更普遍。尿酸结石形成者比钙或磷酸铵镁结石患者年龄更大、体重更重,甘油三酯和血尿酸水平更高。磷酸铵镁结石形成者也比钙结石形成者年龄更大。我们的数据表明,肾结石患者尤其是钙结石形成者中HT的患病率与普通人群相似。高钙尿症作为HT - 尿路结石关联的环节,其作用似乎相当不确定。磷酸铵镁和尿酸结石形成者患HT的风险高于钙结石形成者,可能是由于年龄较大或存在相关的代谢异常。