-
摘要: 泌尿系结石与高血压都是常见疾病，同时罹患这两种疾病者并不少见。对身患两种疾病的患者，需要同时进行治疗。在治疗高血压的药物中，有4类药物也可用于治疗泌尿系结石，包括：①噻嗪类利尿剂，代表性药物是氢氯噻嗪；②血管紧张素转化酶抑制剂，代表性药物是卡托普利；③二氢吡啶类钙通道阻滞剂，代表性药物是硝苯地平；④α1受体阻滞剂，代表性药物是坦索罗辛。本文从上述药物入手，讨论关于泌尿系结石伴高血压患者的药物治疗。Abstract: Urinary calculi and hypertension are common diseases, and it is also common for patients to suffer from these two diseases simultaneously. Patients suffering from both urinary calculi and hypertension should receive treatments to cure both concurrently. Among the drugs for the treatment of hypertension, there are four types of drugs that could also treat urinary calculi, including thiazide diuretics(i. e., hydrochlorothiazide), angiotensin-converting enzyme inhibitors(i. e., captopril), dihydropyridine calcium channel blockers(i. e., nifedipine), and alpha1-receptor blockers(i. e., tamsulosin). Here we try to discuss the strategy of medication treatment for urinary calculi complicated with hypertension based on the above mentioned drugs.
-
Key words:
- urinary calculi /
- hypertension /
- medication treatment
-
-
表 1 α1受体各亚型在输尿管的分布
亚型 全段 上段 中段 下段 α1A 38% 43% 32% 23% α1B 8% 8% 8% 10% α1D 54% 49% 60% 67% 
下载: 导出CSV
-
[1] 曾国华, 麦赞林, 夏术阶, 等. 中国成年人群尿石症患病率横断面调查[J]. 中华泌尿外科杂志, 2015, 36(7): 528-532. doi: 10.3760/cma.j.issn.1000-6702.2015.07.014
[2] Wang Z, Chen Z, Zhang L, et al. Status of Hypertension in China: Results from the China Hypertension Survey, 2012-2015[J]. Circulation, 2018, 137(22): 2344-2356. doi: 10.1161/CIRCULATIONAHA.117.032380
[3] Bergsland KJ, Worcester EM, Coe FL. Role of proximal tubule in the hypocalciuric response to thiazide of patients with idiopathic hypercalciuria[J]. Am J Physiol Renal Physiol, 2013, 305(4): 592-599. doi: 10.1152/ajprenal.00116.2013
[4] Nijenhuis T, Vallon V, van der Kemp AW, et al. Enhanced passive Ca21 reabsorption and reduced Mg21 channel abundance explains thiazide-induced hypocalciuria and hypomagnesemia[J]. J Clin Invest, 2005, 115(6): 1651-1658. doi: 10.1172/JCI24134
[5] Türk C, Neisius A, Pet ík A, et al. Follow up: Metabolic evaluation and recurrence prevention. EAU guidelines on urolithiasis[OL]. https://uroweb.org/guidelines/urolithiasis.
[6] 叶章群, 邓耀良等, 泌尿系结石的诊断治疗指南[M]//黄健. 中国泌尿外科和男科疾病诊疗指南. 2019版, 北京: 科学出版社, 2019: 237-267.
[7] Fink HA, Wilt TJ, Eidman KE, et al. Medical management to prevent recurrent nephrolithiasis in adults: a systematic review for an American College of Physicians Clinical Guideline[J]. Ann Intern Med, 2013, 158(7): 535-543. doi: 10.7326/0003-4819-158-7-201304020-00005
[8] Preminger GM, Pak CY. Eventual attenuation of hypocalciuric response to hydrochlorothiazide in absorptive hypercalciuria[J]. J Urol, 1987, 137(6): 1104-1109. doi: 10.1016/S0022-5347(17)44415-6
[9] Cunha TDS, Gomes SA, Heilberg IP. Thiazide and thiazide-like diuretics in nephrolithiasis[J]. J Bras Nefrol, 2021, 43(1): 103-109. doi: 10.1590/2175-8239-jbn-2019-0148
[10] Anna L Zisman. Effectiveness of Treatment Modalities on Kidney Stone Recurrence[J]. Clin J Am Soc Nephrol, 2017, 12(10): 1699-1708. doi: 10.2215/CJN.11201016
[11] 国家卫生计生委合理用药专家委员会, 中国医师协会高血压专业委员会. 高血压合理用药指南(第2版)[J/OL]. 中国医学前沿杂志(电子版), 2017, 9(7);28-124.
[12] Sloand JA, Izzo JL Jr. Captopril reduces urinary cystine excretion in cystinuria[J]. Arch Intern Med, 1987, 147(8): 1409-1412. doi: 10.1001/archinte.1987.00370080045011
[13] Perazella MA, Buller GK. Successful treatment of cystinuria with captopril[J]. Am J Kidney Dis, 1993, 21(5): 504-507. doi: 10.1016/S0272-6386(12)80396-9
[14] Cohen TD, Streem SB, Hall P. Clinical effect of captopril on the formation and growth of cystine calculi[J]. J Urol, 1995, 154(1): 164-166. doi: 10.1016/S0022-5347(01)67256-2
[15] Coulthard M, Richardson J, Fleetwood A. Captopril is not clinically useful in reducing the cystine load in cystinuria or cystinosis[J]. Pediatr Nephrol, 1991, 5(1): 98. doi: 10.1007/BF00852860
[16] Nicholas S Kowalczyk, Anna L Zisman. Cystinuria: Review of a Life-long and Frustrating Disease[J]. Yale J Biol Med, 2021, 94(4): 681-686.
[17] Pearle MS, Goldfarb DS, Assimos DG, et al. American Urological Assocation. Medical management of kidney stones: AUA guideline[J]. J Urol, 2014, 192(2): 326-324.
[18] Andersson KE, Forman A. Effects of calcium channel blockers on urinary tract smooth muscle[J]. Acta Pharmacol Toxicol(Copenh), 1986, 58 Suppl 2: 193200.
[19] Hollingsworth JM, Rogers MA, Kaufman SR, et al. Medical therapy to facilitate urinary stone passage: A metaanalysis[J]. Lancet, 2006, 368(9542): 11711179.
[20] Santicioli P, Carganico G, Meini S, et al. Modulation by stereoselective inhibition of cyclo-oxygenase of electromechanical coupling in the guineapig isolated renal pelvis[J]. Br J Pharmacol, 1995, 114(6): 1149-1158. doi: 10.1111/j.1476-5381.1995.tb13327.x
[21] Balci M, Tuncel A, Aydin O, et al. Tamsulosin versus Nifedipin in medical expulsive therapy for distal ureteral stones and the predictive value of Hounsfield unit in stone expulsion[J]. Ren Fail, 2014, 36(10): 1541-1544. doi: 10.3109/0886022X.2014.959023
[22] Skolarikos A, Grivas N, Kallidonis P, et al. Members of RISTA Study Group. The Efficacy of Medical Expulsive Therapy(MET)in Improving Stone-free Rate and Stone Expulsion Time, After Extracorporeal Shock Wave Lithotripsy(SWL)for Upper Urinary Stones: A Systematic Review and Metanalysis[J]. Urology, 2015, 86(6): 1057-1064. doi: 10.1016/j.urology.2015.09.004
[23] 周孟能, 李庆庸, 罗宏丽. 硝苯地平辅助治疗输尿管结石的有效性和安全性Meta分析[J]. 临床合理用药杂志, 2017, 10(12): 24-27, 30. https://www.cnki.com.cn/Article/CJFDTOTAL-PLHY201712012.htm
[24] Yamada S, Ito Y. α(1)-Adrenoceptors in the urinary tract[J]. Handb Exp Pharmacol, 2011, (202): 283-306.
[25] Archer M, Dogra N, Dovey Z, et al. Role of α-and β-adrenergic signaling in phenotypic targeting: significance in benign and malignant urologic disease[J]. Cell Commun Signal, 2021, 19(1): 78. doi: 10.1186/s12964-021-00755-6
[26] Guimaraes S, Moura D. Vascular adrenoceptors: an update[J]. Pharmacal Rev, 2001, 53: 319-356.
[27] Sigala S, Dellabella M, Milanese G, et al. Evidence for the presence of alpha1 adrenoceptor subtypes in the human ureter[J]. Neurourol Urodyn, 2005, 24(2): 142-148. doi: 10.1002/nau.20097
[28] Itoh Y, Kojima Y, Yasui T, et al. Examination of alpha1 adrenoceptor subtypes in the human ureter[J]. Int J Urol, 2007, 14(8): 749-753. doi: 10.1111/j.1442-2042.2007.01812.x
[29] Villa L, Capogrosso P, Capitanio U, et al. Silodosin: An Update on Efficacy, Safety and Clinical Indications in Urology[J]. Adv Ther, 2019, 36(1): 1-18. doi: 10.1007/s12325-018-0854-2
[30] Scotland KB, Bidnur S, Wang L, et al. Mediators of human ureteral smooth muscle contraction-a role for erythropoietin, tamsulosin and Gli effectors[J]. Transl Androl Urol, 2021, 10(7): 2953-2961. doi: 10.21037/tau-20-1342
[31] Dahm P, Sukumar S, Hollingsworth JM. Medical Expulsive Therapy for Distal Ureteral Stones: The Verdict is In[J]. Eur Urol, 2018, 73(3): 392-393. doi: 10.1016/j.eururo.2017.11.010
[32] Ye Z, Zeng G, Yang H, et al. Efficacy and Safety of Tamsulosin in Medical Expulsive Therapy for Distal Ureteral Stones with Renal Colic: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial[J]. Eur Urol, 2018, 73(3): 385-391. doi: 10.1016/j.eururo.2017.10.033
[33] 范志楠, 施鸿金, 张劲松, 等. 坦索罗辛联合双氯芬酸钠治疗输尿管结石的疗效与安全性的meta分析[J]. 临床泌尿外科杂志, 2022, 37(2): 138-145. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW202202013.htm
[34] Dellis AE, Keeley FX Jr, Manolas V, et al. Role of αblockers in the treatment of stentrelated symptoms: a prospective randomized control study[J]. Urology, 2014, 83(1): 56-61. doi: 10.1016/j.urology.2013.08.067
[35] Sigala S, Dellabella M, Milanese G, et al. Evidence for the presence of alpha1 adrenoceptor subtypes in the human ureter[J]. Neurourol Urodyn, 2005, 24(2): 142-148. doi: 10.1002/nau.20097
[36] Campschroer T, Zhu X, Vernooij RWM, et al. α-blockers as medical expulsive therapy for ureteral stones: a Cochrane database of systematic reviews[J]. BJU Int, 2018, 122(6): 932-945. doi: 10.1111/bju.14454
-
| 引用本文: |
张东方, 孙璇. 泌尿系结石伴高血压患者的药物治疗[J]. 临床泌尿外科杂志, 2022, 37(11): 872-875. doi: 10.13201/j.issn.1001-1420.2022.11.015
|
| Citation: |
ZHANG Dongfang, SUN Xuan. Medication treatment of urinary calculi complicated with hypertension[J]. J Clin Urol, 2022, 37(11): 872-875. doi: 10.13201/j.issn.1001-1420.2022.11.015
|