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各种胃肠病患者发生肾结石的可能性增加,其原因是:(1)原发疾病对尿液成份和胃肠道功能均有不利影响(甲状旁腺机能亢进),(2)治疗胃肠病致使有可能在尿路中沉淀的物质摄入增加(用含钙抗酸药治疗溃疡病),(3)胃肠病使尿量和尿液成份改变。近10年来有几项研究提示,炎性肠病患者(特别是曾用手术矫治者)肾结石的发病率增高;但这些研究往往缺乏明确的对照组。这些患者中所发现的结石主要为含钙结石,但尿酸占很大百分率。由于这些患者并无尿酸尿,是由经回肠造口丧失液体所致尿量明显减少和持续分泌酸性尿液使溶解度很小的尿酸发生沉淀,故增加液体摄入以保持足够的排尿量应可预防复发性尿酸结石,对用此法无效的患者可考患用别嘌呤醇(allopurinol)治疗。
The incidence of kidney stones in a variety of gastrointestinal diseases is increased because (1) the primary disease has an adverse effect on urinary composition and gastrointestinal function (hyperparathyroidism), (2) Enteropathy causes increased intake of substances that may precipitate in the urinary tract (treatment of ulcer disease with calcium-containing antacids), (3) gastrointestinal disorders that alter urine output and urinary composition. Several studies over the past decade have suggested that the incidence of kidney stones is increased in patients with inflammatory bowel disease, especially those who have undergone surgery; however, these studies often lack clear controls. The stones found in these patients were mainly calcium-bearing stones, but uric acid accounted for a large percentage. Since uric acid was not present in these patients, the urine output was significantly reduced by the loss of fluid via the ileostomy and continued secretion of acidic urine resulted in the precipitation of uric acid, which had a low solubility. Increasing fluid intake to maintain sufficient urinary output should be possible Prevention of recurrent uric acid stones, in patients with this method can be tested with allopurinol (allopurinol) treatment.