尿酸结石的诊断和防治研究进展

董浩; 高小峰

doi:10.13201/j.issn.1001-1420.2023.01.014

尿酸结石的诊断和防治研究进展

董浩¹,
高小峰^1,Δ, ,

- 海军军医大学第一附属医院泌尿外科(上海，200433)

详细信息

通讯作者: 高小峰，E-mail：gxfdoc@sina.com

^Δ审校者

中图分类号: R691.4

收稿日期: 2022-08-04

刊出日期: 2023-01-06

Progress in the diagnosis, treatment and prevention of uric acid stones

DONG Hao¹,
GAO Xiaofeng^1,Δ, ,

- Department of Urology, First Affiliated Hospital of Naval Medical University, Shanghai, 200433, China

More Information

Corresponding author: GAO Xiaofeng, E-mail: gxfdoc@sina.com

Received Date: 04 August 2022

Publish Date: 06 January 2023

摘要

摘要: 尿酸结石的发病率逐年升高，近些年来，针对尿酸结石的诊断和防治措施取得了一定进展，根据尿酸结石的透X射线性和可溶性的特点，可以进行较为明确的诊断，并选择合适的溶石方案和预防策略，从而避免手术带来的创伤和减轻反复手术治疗的经济负担。然而在我国，尤其在一些基层医院，尿酸结石的诊断和恰当的治疗仍未引起足够的重视。因此，本文对尿酸结石的诊断和防治进展做一总结，呼吁国内泌尿外科同行，针对尿酸结石进行科学有效的鉴别诊断，并提供给这类患者合适的治疗方案和预防措施。
- 尿酸结石 /
- 诊断 /
- 药物治疗 /
- 预防策略
Abstract: The incidence of uric acid stones increased year by year. In recent years, the diagnosis, prevention and treatment measures of uric acid stones have made certain progress. According to the radiolucent feature and the soluble characteristic of uric acid stones, a more definite diagnosis can be made, and the appropriate stone dissolution and prevention strategies were selected so as to avoid the surgical trauma and reduce the economic burden of repeated surgery. However, in China, especially in some basic-level hospitals, the diagnosis and appropriate treatment of uric acid stones still do not attract enough attention. Therefore, we summarized the progress of diagnosis, prevention and treatment of uric acid stones, and would like to call on domestic urology colleagues to carry out scientific and effective differential diagnosis for uric acid stones, and provide appropriate treatment plan and prevention strategies for such patients.
- uric acid stones /
- diagnosis /
- pharmacotherapy /
- prevention strategies

HTML全文

图 1 KUB和CT表现

下载: 全尺寸图片幻灯片

图 2 枸橼酸氢钾钠颗粒治疗尿酸结石效果

下载: 全尺寸图片幻灯片

参考文献(20)

[1]	Abou-Elela A. Epidemiology, pathophysiology, and management of uric acid urolithiasis: A narrative review[J]. J Adv Res, 2017, 8(5): 513-527. doi: 10.1016/j.jare.2017.04.005
[2]	Zhang S, Huang Y, Wu W, et al. Trends in urinary stone composition in 23, 182 stone analyses from 2011 to 2019: a high-volume center study in China[J]. World J Urol, 2021, 39(9): 3599-3605. doi: 10.1007/s00345-021-03680-y
[3]	Sakhaee K. Epidemiology and clinical pathophysiology of uric acid kidney stones[J]. J Nephrol, 2014, 27(3): 241-245. doi: 10.1007/s40620-013-0034-z
[4]	Trinchieri A, Montanari E. Prevalence of renal uric acid stones in the adult[J]. Urolithiasis, 2017, 45(6): 553-562. doi: 10.1007/s00240-017-0962-5
[5]	张勇, 陈站, 陈建刚, 等. 尿酸结石致病相关基因的研究进展[J]. 临床泌尿外科杂志, 2021, 36(2): 148-151. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW202102016.htm
[6]	Lieske JC, Rule AD, Krambeck AE, et al. Stone composition as a function of age and sex[J]. Clin J Am Soc Nephrol, 2014, 9(12): 2141-2146. doi: 10.2215/CJN.05660614
[7]	Trinchieri A, Montanari E. Biochemical and dietary factors of uric acid stone formation[J]. Urolithiasis, 2018, 46(2): 167-172. doi: 10.1007/s00240-017-0965-2
[8]	Rendina D, De Filippo G, D'Elia L, et al. Metabolic syndrome and nephrolithiasis: a systematic review and meta-analysis of the scientific evidence[J]. J Nephrol, 2014, 27(4): 371-376.
[9]	曹程, 范波, 阳东荣, 等. 尿酸结石与血脂异常的相关性研究及危险因素分析[J]. 中华泌尿外科杂志, 2020, 41(4): 303-308.
[10]	Shekarriz B, Stoller ML. Uric acid nephrolithiasis: current concepts and controversies[J]. J Urol, 2002, 168(4 Pt 1): 1307-1314.
[11]	Marchini GS, Sarkissian C, Tian D, et al. Gout, stone composition and urinary stone risk: a matched case comparative study[J]. J Urol, 2013, 189(4): 1334-1339. doi: 10.1016/j.juro.2012.09.102
[12]	Tran T, Maalouf NM. Uric acid stone disease: lessons from recent human physiologic studies[J]. Curr Opin Nephrol Hypertens, 2020, 29(4): 407-413. doi: 10.1097/MNH.0000000000000610
[13]	Kambadakone AR, Eisner BH, Catalano OA, et al. New and evolving concepts in the imaging and management of urolithiasis: urologists' perspective[J]. Radiographics, 2010, 30(3): 603-623. doi: 10.1148/rg.303095146
[14]	Lidén M. A new method for predicting uric acid composition in urinary stones using routine single-energy CT[J]. Urolithiasis, 2018, 46(4): 325-332. doi: 10.1007/s00240-017-0994-x
[15]	Wiessmeyer JR, Ozimek T, Struck JP, et al. Comprehensive Nomogram for Prediction of the Uric Acid Composition of Ureteral Stones as a Part of Tailored Stone Therapy[J]. Eur Urol Focus, 2022, 8(1): 291-296. doi: 10.1016/j.euf.2021.02.001
[16]	Morgan MS, Pearle MS. Medical management of renal stones[J]. BMJ, 2016, 352: i52.
[17]	Ngo TC, Assimos DG. Uric Acid nephrolithiasis: recent progress and future directions[J]. Rev Urol, 2007, 9(1): 17-27.
[18]	Pejcić T, Marković B, Djurasić L, et al. The dissolution of multiple renal uric acid stones via percutaneous nephrostomy in the patient with a solitary kidney[J]. Acta Chir Iugosl, 2012, 59(3): 93-96. doi: 10.2298/ACI1203093P
[19]	Reichard C, Gill BC, Sarkissian C, et al. 100% uric acid stone formers: what makes them different?[J]. Urology, 2015, 85(2): 296-298. doi: 10.1016/j.urology.2014.10.029
[20]	Costa-Bauza A, Grases F, Calvó P, et al. Effect of Consumption of Cocoa-Derived Products on Uric Acid Crystallization in Urine of Healthy Volunteers[J]. Nutrients, 2018, 10(10): 1516. doi: 10.3390/nu10101516