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題名 | Urinary N[fed5]-Acetyl-Sulfamethoxazole Stone:A Forgotten Complication of Cotrimoxazole=N[fed5]-Acetyl-Sulfamethoxazole尿路結石:一種使用Cotrimoxazol磺胺劑常被遺忘之副作用 |
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作者 | 李瀛輝; 黃榮慶; Lee, Ying-huei; Huang, Jong-khing; |
期刊 | 中華民國泌尿科醫學會雜誌 |
出版日期 | 19980300 |
卷期 | 9:1 1998.03[民87.03] |
頁次 | 頁29-31 |
分類號 | 415.842 |
語文 | eng |
關鍵詞 | 尿路結石; Urinary calculi; Trimethoprim; Sulfamethoxazole; N[fed5]-acetyl-sulfamethoxazole; |
中文摘要 | Sulfamethoxazole和trimethoprim之復合劑(cotrimoxazole)常被用來治療長期或複雜 性的秘尿道感染。磺胺劑容易在酸性尿液中沉澱。 我們報告一位91歲病患,因為急性尿閉症置放導尿管並且接受數週cotrimoxazole治療。 當病患接受經尿道攝護腺切除手術時,同時發現膀胱中有許多扁平黃褐色結石。結石成份經 由紅外線光譜分析儀化驗證實是N -acetyl-sulfamethoxazole結石。此結石屬cotrimoxazole 之代謝物。我們認為N -acetyl-sulfamethoxazole結石雖然很少在英文文獻中被報導,但是 其發生應該常被忽略。我們建議當必須使用cotrimoxazole磺胺劑,尤其必須長期使用或者 原先尿液偏酸性性之病人,在服藥同時應該多喝水並且注意N -acetyl-sulfamethoxazole結 石產生的可能性。 |
英文摘要 | The combination of sulfamethoxazole and trimethoprim (cotrimoxa-zole) is frequently used for the purpose of long-standing or complicated urinary and genital tract infection. Sulfonamides are known to precipitate in the urine, especially in urine with an acidic pH. Herein, we report a 91-year-old male who was admitted because of acute urinary retention. He underwent transurethral resection of the prostate (resected adenoma: 52g) smoothly. During the operation, multiple flat, yellow-brownish stones were noted. Stones, analyzed by infrared spectrophotmeter, proved to be N -acetyl-sulfamethoxazole stone,which are pure metabolites of the cotrimoxazole. The N –acetyl-sulfamethoxazole stone is rare but possible under-diagnosed and there are few recent relevant articles in the English literature. It is reasonable to take a cautious attitude toward the use of cotrimoxazole as a long-term treatment especially in patients who already have acidic wrine. |
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