تقصي الاضطرابات الاستقلابية لدى المرضى المراجعين لمركز تفتيت الحصيات في مشفى الأسد الجامعي باللاذقية.
Abstract
إن الهدف من الدراسة هو تقييم الاضطرابات الاستقلابية التي يمكن أن توجد لدى المرضى المراجعين لمركز تفتيت الحصيات في مشفى الأسد الجامعي باللاذقية, وذلك لمعرفة أكثر الاضطرابات شيوعاً لدى هؤلاء المرضى, مما قد يسمح بعلاج المرض المسبب واتخاذ التدابير الملائمة التي تهدف إلى التقليل من عودة تشكل الحصيات .
أجريت الدراسة على 106 مريضاً، (62ذكر و44 أنثى) ،كان متوسط أعمارهم (40,5± 25) سنة راجعوا مركز تفتيت الحصيات في مشفى الأسد الجامعي باللاذقية خلال الفترة الممتدة بين (أيلول 2007 وأيلول 2008). حيث تم إجراء تحليل كيميائي للمصل تضمن (كالسيوم الدم, البيكربونات, حمض البول, البوتاسيوم، هرمون جارات الدرق في حال وجود ارتفاع في كالسيوم الدم), عينة بول تضمنت ( PH البول, كالسيوم, كرياتينين) وحساب مشعر كالسيوم/كرياتينين لتقدير مستوى ارتفاع الكلس في البول.
تبيَن بنتيجة الدراسة وجود اضطراب استقلابي عند 65 مريضاً (61,33%) حيث ظهر لدى 53 مريضاً منهم اضطراب استقلابي معزول، بينما ظهرلدى 6 مرضى اضطراب استقلابي مشترك.
الاضطراب الاستقلابي الأكثر شيوعاً عند هؤلاء المرضى كان فرط كلس البول (46/106) حالة (43.39%).
تشير هذه الدراسة إلى أن السبب الرئيسي لتشكل الحصيات هو ارتفاع كلس البول الأساسي الذي ينجم عن تضافر عوامل محيطية ووراثية, وهذا يفتح المجال لإجراء دراسات أكثر عمقاً خصوصاً فيما يتعلق بدور البيئة والغذاء في تشكل الحصيات ونكسها.
The objective of our study was to evaluate the prevalence of metabolic abnormalities found in outpatients admitted the lithotripsy centre at Al-Assad University Hospital in Lattakia and determine the most common metabolic disorders in these patients which would permit treating the causes and taking measures to prevent the disease recurring. The study included 106 patients (62M, 44F, aged 40.5 ± 25) who were admitted the lithotripsy centre at AL-Assad University Hospital in Lattakia from September 2007 to September 2008. Serum was taken for biochemical analysis, including (Calcium, serum uric acid, bicarbonate, potassium, and parathyroide hormone). A random urine sample was analyzed for calcium/ creatinine ratio, PH urine. Among those patients, 65 (61.3%) showed metabolic changes, 53 patients had isolated metabolic change, and 6 had mixed changes. The main detected disorder was hypercalciuria (46/106) (43.39%).
This study showed that the principal cause of nephrolithiasis was idiopathic hypercalciurea, being the result of the interplay between genetic background and environment. This would indicate the importance of conducting more in-depth studies mainly focusing on the role of environment and nutrition in forming of urine stones and their recurrence.
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