Pak C Y
University of Texas Southwestern Medical Center, Dallas 75235-8885, USA.
Am J Med Sci. 1997 Apr;313(4):215-9. doi: 10.1097/00000441-199704000-00004.
Considerable progress has been made regarding pathophysiology, diagnosis, and medical prevention of recurrent renal stone formation. The medical approach is not applied widely because of the availability of extracorporeal shockwave lithotripsy and the complexity of medical diagnostic and treatment modalities. In this review, a simplified program for the medical management of stones is described. From analysis of stone risk factors in 24-hour urine specimens, uncomplicated calcium stone disease is separated from other stone diseases. The uncomplicated calcium stone disease, comprising the illness in the majority of patients with recurrent renal calculi, is characterized by normocalcemia, normouricemia, calcium stones, and the absence of urinary tract infection, bowel disease, or marked hyperoxaluria. Uncomplicated calcium stone disease is separated into a hypercalciuric group and a normocalciuric group. In the simplified treatment program, the hypercalciuric group would be offered thiazide plus potassium citrate, whereas the normocalciuric group would receive potassium citrate alone.
在复发性肾结石形成的病理生理学、诊断和医学预防方面已经取得了相当大的进展。由于体外冲击波碎石术的可用性以及医学诊断和治疗方式的复杂性，医学方法并未得到广泛应用。在这篇综述中，描述了一种简化的结石医学管理方案。通过对24小时尿液标本中的结石危险因素进行分析，将单纯性钙结石病与其他结石病区分开来。单纯性钙结石病包括大多数复发性肾结石患者的疾病，其特征是血钙正常、血尿酸正常、钙结石以及无尿路感染、肠道疾病或明显高草酸尿症。单纯性钙结石病分为高钙尿组和正常钙尿组。在简化治疗方案中，高钙尿组将使用噻嗪类药物加柠檬酸钾，而正常钙尿组将单独接受柠檬酸钾治疗。
