摘要
【目的】探索枸橼酸钾对含钙上尿路结石患者尿液成石危险因素的影响。
【方法】本研究入选患有含钙上尿路结石的住院和门诊患者共80例,随机将患者分成两组(对照组和研究组)。对照组40例,嘱多饮水,避免高钙、高草酸、高动物蛋白等饮食;研究组40例,除避免高钙、高草酸、高动物蛋白等饮食和多饮水外,加服枸橼酸钾2g/次,每日3次,持续服用2个月。对入选的患者于服药后分别测24h尿生化参数,分析治疗前后尿液成分是否有变化。
【结果】研究共纳入病人80例,其中有68例完成研究(研究组35例,对照组33例),研究脱落率15%。经过2个月治疗后,研究组:24h尿钙量由5.67±1.73mmol/24h降至3.51±1.49mmol/24h(P<0.05);24小时尿钾量由29.53±11.55mmol/24h提高到58.96±11.25mmol/24h(P<0.05); 24小时尿草酸量由121.38±107.81mmol/24h降至59.53±50.66mmol/24h (P<0.05);24小时尿枸橼酸量由132.60±89.70mg/24h提高到339.84±204.86mg/24h (P<0.05);治疗前后研究组24小时尿钙、尿钾、尿草酸、尿枸橼酸变化均有统计学意义。而24小时尿镁、尿磷、尿尿酸的变化均无统计学意义(P>0.05)。对照组24小时尿钙、尿钾、尿草酸、尿枸橼酸、尿镁、尿磷、尿尿酸的变化均无统计学意义(P>0.05)。经t检验,两组差别有统计学意义(P<0.05)。
【结论】枸橼酸钾可明显提高含钙上尿路结石患者尿枸橼酸和尿钾含量,降低尿钙和尿草酸浓度。应用枸橼酸钾降低含钙上尿路结石复发可能与这些因素有关。
【Objective】: To investigate the change of the risk factors of stone forming in patients with upper calcium stones after oral administration of potassium citrate .
【Meterials and Methods】: Eighty patients of upper urinary calcium stone were randomly allocated into the study group and the control group.The study gro- up includs 40 cases who took potassium citrate 6g/d for two months; the control group includs 40 cases who did not take potassium citrate. 24-hour uri- nary chemistries of study group and control group were measured at baseline and after 2 months of treatment respectively.
【Result】: There are 35 cases in study group and 33 cases in cont- rol group who went through the complete investigation. Study group: After 2 months of treatment ,mean urinary citrate increased from 132.60±89.70 mg/24h to 339.84±204.86mg/24h(P<0.05)and mean urinary potassium increased from 29.53±11.55mmol/24h to 58.96±11.25mmol /24h(P<0.05). Mean calcium excretion decreased from 5.67±1.73 mmol /24h to 3.51±1.49 mmol/24h(P<0.05)and Mean urinary oxalate excretion decreased from 121.38±107.81 mmol/24h to 59.53±50.66 mmol/24h(P<0.05). However there was no significant change of the risk factors of stone forming in the control group (P >0.05).
【Conclusion】: Potassium citrate can significantly increase urinary citrate,urinary potassium and decrease calcium,oxalic acid of patients with upper calcium stones diseases.Long-term application of Potassium citrate may reduce the recurrence of upper urinary tract calculi.
引文
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