Laerum E
Seksjon for allmennmedisin Universitetet i Oslo.
Tidsskr Nor Laegeforen. 1996 Oct 10;116(24):2897-902.
The author reviews the epidemiological, etiological aspects of stone disease of the urinary tract, and prophylactic treatment. The occurrence of urolithiasis has increased considerably since the second world war and now affects 10% of the adult male and 4% of the adult female population. In Norway the yearly incidence of patients presenting with urinary stone colic in general practice is two per 1,000 inhabitants. Urinary calculi form when the concentration of the crystal-forming substances such as calcium oxalate, calcium phosphate, uric acid and cystine exceed their solubility. Important risk factors for stone formation are low fluid intake and high consumption of animal protein. Etiological examination and stone prophylactic treatment should reflect the most prevalent types of stone disease. An examination programme that probably can reveal one or several causes of the stone disease in about 60-70% of the patients is described. The recommended examinations car be performed in general practice. Prophylactic treatment in terms of dietary advice and fluid intake is suggested. In patients with a high recurrence rate of stone formation prophylactic drug treatment with tiazid or alluopurinol should be considered. The beneficial effect of the treatment is well documented.
作者回顾了尿路结石疾病的流行病学、病因学方面以及预防性治疗。自第二次世界大战以来，尿石症的发病率大幅上升，目前影响着10%的成年男性和4%的成年女性人口。在挪威，全科医疗中每年因尿石绞痛就诊患者的发病率为每1000名居民中有两人。当草酸钙、磷酸钙、尿酸和胱氨酸等晶体形成物质的浓度超过其溶解度时，就会形成尿路结石。结石形成的重要风险因素是液体摄入量低和动物蛋白消耗高。病因学检查和结石预防性治疗应反映最常见的结石疾病类型。文中描述了一个检查方案，该方案可能在约60 - 70%的患者中揭示结石疾病的一个或多个病因。推荐的检查可在全科医疗中进行。建议在饮食建议和液体摄入方面进行预防性治疗。对于结石形成复发率高的患者，应考虑使用噻嗪类药物或别嘌呤醇进行预防性药物治疗。该治疗的有益效果有充分的文献记载。
