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題名 | Clinical Analysis of Patients with Urinary Calcium Phosphate Stones=磷酸鈣尿路結石之臨床分析 |
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作者 | 周以和; 王巺玄; 李經家; | 書刊名 | 臺灣泌尿科醫學會雜誌 |
卷期 | 20:1 2009.03[民98.03] |
頁次 | 頁21-24+43 |
分類號 | 415.842 |
關鍵詞 | 磷酸鈣; 尿路結石; Urolithiasis; Calcium phosphate stone; Stone analysis; |
語文 | 英文(English) |
英文摘要 | Calcium phosphate stones are less common than calcium oxalate stones in urinary stone disease. Data linking particular urinary stone risk factors to the formation of calcium phosphate stones are sparse. In this study, we collected data on 55 patients with stones composed only of calcium phosphate and attempted to evaluate the clinical characteristics of this disease. The incidence of pure calcium phosphate stones in our institute was 9.3% of all urinary calculi. The gender ratio was of about 1:1. The mean age was 54.5±14.6 years, and the mean body-mass index (BMI) was 24.27±3.5. Composition analysis revealed apatite in 43 patients (78%), brushite in 6 patients (11%), and mixed apatite-brushite stones in 6 patients (11%). With regard to the management of calcium phosphate stones, repeated extracorporeal shock wave lithotripsy (ESWL) was performed in 21 patients (70%), repeated transurethral ureteroscopic lithotripsy (URSL) was performed in 4 patients (18%). Among all patients, 67% had combined urinary tract infection; urine culture revealed Proteus mirabilis in 8 patients (47%), Escherichia coli in 7 patients (41%), and Pseudomonas sp. in 2 patients (12%). The mean urine pH of all the patients was 7.1±0.6, and the mean urine specific gravity was 1.014. In conclusion, the characteristic clinical findings of calcium phosphate stone formers in our study were an equal gender ratio, a high recurrence rate, a high infection rate, a high urine pH, and a high urine specific gravity. Because the clinical picture differs between calcium phosphate stone and general stone populations, we believe some unknown fundamental difference exists in the formation of calcium phosphate stones. Different approaches to the treatment and prevention of recurrent stone disease are necessary. |
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