Clinical Study of Uric Acid Urolithiasis

尿酸尿路結石的臨床研究

周以和(Yii-Her Chou) ； 李威明(Wei-Ming Li) ； 李經家(Ching-Chia Li) ； 黃書彬(Shu-Pin Huang) ； 蕭錫麟(Chia-Chu Liu) ； 吳文正(Wen-Jeng Wu) ； 劉家駒(Hsi-Lin Hsiao) ； 張圖豪(Tu-Hao Chang) ； 阮雍順(Yung-Shun Juan) ； 蘇健裕(Chien-Yu Su) ； 許杏(Hsing Hsu) ； 黃俊雄

《The Kaohsiung Journal of Medical Sciences》 23卷6期 (2007/06) Pp. 298-301

摘要

尿酸成份的尿路結石形成的原因複雜，為了探討尿酸結石的臨床及生化表現，本文收集自2004年1月至2005年12月共46病例做研究，結石成份經由傳立葉紅外線圖譜分析而知，46尿酸結石病例中，男性有39位(84.8%)，女性7位(15.2%),平均年齡61.5±10.6歲，平均體質指數(BMI)為26.7±3.1kg/平方公尺。結石部位在腎臟有10位(21.70%)，輸尿管22位(41.8%)，膀胱14位(30.50%)。多發性結石有36位(78.3%)，患者同時合併糖尿病有11位(23.9%)，高血壓有23位(50%)，痛風13位(28.2%)，前列腺肥大14位(30.4%)。患者肌酸酐平均值為1.6±0.6mg/dL，尿酸平均值為7.6±1.8mg/dL，尿液酸鹼度(PH)平均值為5.42±0.46。其中肌酸酐大於1.4mg/dL者有27位(58%)。大體而言，尿酸結石的患者以男性較多，年紀較大，體質指數較高，結石部位較為多發性，尿液酸鹼度偏低，血中尿酸值偏高。其中超過一半的病例有腎功能不良的現象，是值得注意的。

關鍵字

體質指數 ； 尿酸結石 ； 尿路結石

並列摘要

Uric acid urolithiasis develops from various causes. To investigate the clinical and biochemical presentation of patients with uric acid urolithiasis, a retrospective study was designed. Atotal of 46 cases were enrolled between January 2004 and December 2005. The compositions of the stones were analyzed by infrared spectrophotometry. There were 39 males (84.8%) and seven females (15.2%), with a mean age of 61.5±10.6 years and mean body mass index (BMI) of 26.7±3.1kg/m^2. The stone location was kidney in 10 (21.7%), ureter in 22 (41.8%), and bladder in 14 (30.5%). Multiple stones were diagnosed in 36 patients (78.3%). Pre-existing comorbidities included diabetes mellitus in 11 patients (23.9%), hypertension in 23 (50%), gout in 13 (28.2%), and benign prostatic hyperplasia in 14 (30.4%). Mean serum creatinine and uric acid was 1.6±0.6mg/dL and 7.6±1.8 mg/dL, respectively. There were 27 patients (58%) with creatinine＞1.4 mg/dL. The mean urinary pH was 5.42±0.46. Patients with uric acid urolithiasis were predominantly male, older, with higher BMI, multiple stone presentation, with lower urinary pH, and hyperuricemia. Exacerbation of the renal function should also be of concern because of the high proportion of patients with renal insufficiency diagnosed in this study.

並列關鍵字

body mass index ； uric acid ； urolithiasis