再発性特発性蓚酸カルシウム尿路結石症に対するアロプリノール(ザイロリック)の結石再発予防効果の検討

Abstract

1) 150例の再発性・特発性蓚酸カルシウム尿路結石症を対象として, 最低2年間を目標として, アロプリノール投与による結石再発予防の臨床的検討をおこなった.2)検討可能症例134例(男性113例, 女性21例, 平均年齢42.7歳)を, 結石の発生・再発様式により多発型23例とepisode型111例に分類し, 全例について結石の再発・増大の有無を, episode型については統計学的にも治療前後の再発率の検討をおこなった.3)全症例の結石再発・増大に関しては, 多発型23例中19例に再発・増大を認めず, 4例のみに増大を認めた.episode型111例については59例に再発を認めず, 52例に再発を認めた.134例全例を通じては78例(58.2%)に再発または既存結石の増大は認めず, 56例(41.8%)に再発・増大を認めた.4) episode型111例のアロプリノール投与前後の再発率を統計学的に比較した.111例全例の治療前後の再発率, 治療開始時に結石を有しなかった37例の治療前後の再発率, 治療前後2年間ずつの同期間の再発率を比較しえた79例のいずれにおいても, アロプリノール投与により再発率の有意の低下が観察された

We studied the effect of allopurinol on the prevention of stone recurrence in 134 patients with recurrent, idiopathic calcium nephrolithiasis. They consisted of 113 male patients and 21 female, between 16 and 72 years with an average age of 42.7. The patients were divided into two groups according to the type of stone occurrence; those with multiple stones without previous stone episodes (multiple stone group), and the those with recurrent stones (stone episode group). Twenty three patients belonged to the multiple stone group and 111 patients belonged to the stone episode group. The stones in 19 of the 23 patients in the multiple stone group remained stable throughout the study, while stones in 4 grew. Fifty-nine of the 111 patients in the stone episode group were free from recurrence, but the others showed recurrence. Statistical analyses was done on the stone episode group. The stone recurrence rate of all of the 111 cases showed significant decrease during prophylactic treatment with allopurinol (p less than 0.01), although the observation period before treatment was 73.0 +/- 65.8 months and that during and after treatment was 28.2 +/- 12.1 months. During the two years before and after prophylaxis 79 patients also showed a significantly decreased recurrence rate. Moreover, regarding 37 cases without any stones at the start of treatment, stone recurrence rate decreased significantly after the administration of allopurinol. Throughout this study, we used a new method for evaluating reasonable stone recurrence. It did not calculate the number of stones recurred, but the stone-forming circumstance in each kidney.(ABSTRACT TRUNCATED AT 250 WORDS)