更新尿路结石实验室检查分析程序

D. Milenković, A. Vuksanović, N. Lalić, P. S. Simic-Ogrizovic, V. Dopsaj
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引用次数: 0

摘要

尿路结石由于其高复发率(在未经治疗的患者中为50-100%)和20%可能导致慢性肾衰竭,仍然是一个巨大的社会和医疗问题。从这方面来看,对结石形成患者进行充分的临床评估是至关重要的。在生物化学研究中,要有效而理性地发现结石形成的可能原因,就需要适当的分析程序。本方案根据2003年欧洲泌尿科医师协会保健办公室推荐的尿石症指南进行调整。对于已知的结石化学成分、结石原类别和特定危险因素的存在,分析程序可以是最小的(空腹晨尿样本分析、尿培养和血液分析(钙、白蛋白、肌酐、尿酸和结石分析)和扩展(血清和两个后续24小时尿液收集中所有参数的量化,与结石形成和肾功能评估相关)。为了确定代谢紊乱,建议定量测定血清甲状旁腺激素、尿液cAMP和钙、NH4Cl和草酸盐的吸收/负荷试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Update analytic program for laboratory investigation in urinary tract calculosis
Urinary tract calculosis due to it's high recurrence rate (50-100% in untreated patients) and possibility to cause chronic renal failure in 20% still represents a great social and medical problem. From that aspect, an adequate clinical evaluation in stone forming patients is of paramount importance. An effective and rational attitude in detecting possible causes of stone formation demands the adequate analytic program in biochemical investigations. Presented program is adjusted to the guidelines on urolithiasis, recommended by Board EAU (European Association of Urologists) Healthcare Office, for year 2003. Regarding to known chemical stone composition, category of stone former and presence of an specific risk factor, analytic program could be minimal (fasting morning spot urine sample analysis, urineculture and blood analysis (calcium, albumine, creatinine and urate and stone analysis) and extended (quantification of all parameters in serum and in two consequtive 24h urine collections, relevant for stone formation and evaluation of renal function). In order to identify metabolic disorders, an quantification of parathormone in serum, cAMP in urine and absorption/loading tests with calcium, NH4Cl and [12C2] oxalate are recommended.
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