794上部尿路結石症患者の結石成分と臨床的観察 - 当教室における1938年以来48年間における検討 -

Abstract

794例, 865個の上部尿路結石を赤外線分光分析法で分析し, 結石成分を中心に検討を加えた.男女比は3.0:1であるが, 近年女性の比率が増加している.20歳代が最多で, ついで30, 40歳代の順であるが, 近年中高年層の比率が増加している.結石成分は蓚酸カルシウム(CaOX)と燐酸カルシウム(CaP)の混合結石が43.1%と最も多く, ついでCaOX結石39.8%, CaP結石9.6%の順で, 燐酸マグネシウムアンモニウム(MAP)結石は1.6%, 尿酸結石は2.9%であった.性別では, CaOX結石, 尿酸結石, 燐酸塩を含む結石は男性に有意に多く, CaP結石, MAP結石, 燐酸塩を含む結石は女性に有意に多かった.年齢別ではCaP結石, 尿酸結石は60歳以上に高率であった.1965年以降, CaOX結石, 尿酸結石の増加, 燐酸塩を含む結石の減少が認められた.同一人での再発結石の成分は初発結石と同じか, 異なっても初発結石に何らかの塩が加わったあるいは減じたものがほとんどで, 多発結石もほとんどが同一成分であった

During the 48-year period from January, 1938 to December, 1985, upper urinary tract stones obtained from 794 patients were analyzed by infrared spectroscopy in our Department. Their clinical manifestations were studied, mainly in relation to stone composition. The ratio of males to females was 3.0 to 1. In recent years, the incidence of females tended to increase. In the age distribution, twenties were most frequent followed by thirties together with fourties before 1965, but after 1966, the thirties were most frequent, and fourties and fifties increased. The composition of 794 stones was as follows. The most frequent type was calcium oxalate combined with calcium phosphate (43.1%), followed by calcium oxalate (39.8%) and calcium phosphate (9.6%). Magnesium ammonium phosphate stones were found in 1.6% and uric acid stones in 2.9%. Calcium oxalate stones, uric acid stones and oxalate-containing stones were found more frequently in males than in females. On the other hand, magnesium ammonium phosphate stones, calcium phosphate stones and phosphate-containing stones were found less frequently in males than in females. There was a high occurrence of calcium phosphate stones and uric acid stones in patients older than 60 years old. The occurrence of calcium oxalate stones and uric acid stones increased and that of phosphate-containing stones decreased after 1966. Most of the recurrent stones revealed the same or similar composition as the initial stones.