24h尿枸橼酸定量分析在尿石症患者诊治中的意义

目的对30例含钙尿石症患者24h尿枸橼酸排泄进行了病例对照研究，旨在从病因学角度对尿石症的影响因素进行探讨，为临床诊治提供依据。方珐测定30例尿石症患者和30例正常人的24h尿枸橼酸和钙的含量，比较两组的差异；并比较低枸橼酸尿症与高钙尿症与尿石症发病的相关性。结果24h尿枸橼酸的排泄量在结石患者为（224．26±147．63）mg，显著低于正常人（434．58土280．89）mg，且性别差异具有显著性意义，男性低于女性（P〈0．05）。结石患者24h尿液中的枸橼酸／钙比值明显高于正常人（P〈0．05）。低枸橼酸尿症与尿石症发病的相关性高于高钙尿症（P〈0．05）。结论女性24h尿枸橼酸排泄量约为男性的1．4～1．6倍，建议对尿石症患者的代谢评估应考虑性别差异。在结石的代谢评估中，按照性别分类的24h尿枸橼酸／钙比值的降低可能比单纯尿枸橼酸降低更有意义。低枸橼酸尿症在尿石症的代谢评估中可能是比高钙尿症更加重要的指标。

Significance of 24 h urine citrate quantitative analysis for urinary calculus

Objective To explore the relation between renal calculus and 24 h citrate excretion in urine from the view of etiology by a case-control study. Methods 24 h urine of 30 cases of urolithiasis and 30 healthy people were collected. Citrate and calcium for each subject were measured. Results The average level of 24 h citrate excretion in urine of urolithiasis patients was（224.26±147.63） mg,lower than that of healthy people（434.58±280.89） mg, Which was lower in male than in female with gender considered. The average level of 24 h citrate/Ca^2＋ ratio was higher in healthy people than in urolithiasis patients. The disease of hypocitrate was highly related to urolithiasis. Gonclusion Gender should be considered in citrate excretion assessment of metabolic evaluation. 24 h citrate/Ca^2＋ ratio is highly illuminated in metabolic evaluation. The disease of hypocitrate may be the more important causation in urolithiasis than hypercalcium.