血钙和IgA升高及尿路结石家族史可能与强直性脊柱炎合并肾结石相关

作者：G?nüllü E ,et al.

翻译：北医三院翟佳羽

据报道强直性脊柱炎患者中肾结石形成增加，但原因仍不清楚。这项研究的目的是评估强直性脊柱炎患者肾结石形成可能的危险因素。该研究纳入两组强直性脊柱炎患者，合并肾结石（n=30），无肾结石（n=30）以及健康对照（n=20）。基线期和每月共三次评估其甲状旁腺激素、钙、镁、磷、免疫球蛋白A水平以及24小时尿液。合并肾结石的强直性脊柱炎患者组基线期和第3个月血钙水平较无肾结石组更高（基线期：9.53 ± 0.3比9.32 ± 0.3 mg/dl; p < 0.03；第3个月：9.74 ± 0.2比9.56 ± 0.3 mg/dl; p < 0.01）。甲状旁腺素及血镁水平在各组之间无显著差异。在所有评估点，尽管合并肾结石的强直性脊柱炎患者组尿钙分泌较无肾结石组更高，但无统计学差异。肾结石患者较健康对照者免疫球蛋白a水平更高。在第2个月评估点，合并肾结石的强直性脊柱炎患者较无肾结石组免疫球蛋白a水平更高（276 ± 102比219 ± 104 mg/dl, p < 0.002）。血钙及免疫球蛋白a水平升高及尿路结石家族史提示强直性脊柱炎患者合并肾结石。

附原文：It has been reported that renal stone formation increased in patients with ankylosing spondylitis (AS). However, its reason remains unclear. The aim of this study was to evaluate serially the possible risk factors for renal stone formation in AS patients. Two groups consisted of AS patients with renal stone (n = 30), AS patients without renal stone (n = 30), and 20 healthy controls (HC) were included to the study. Parathyroid hormone, calcium, magnesium, phosphorus and immunoglobulin A levels and 24 h urine were evaluated at baseline, and three times monthly. Serum calcium levels were higher in AS patients with urolithiasis than those without at baseline and third-month evaluation (baseline: 9.53 ± 0.3 vs 9.32 ± 0.3 mg/dl; p < 0.03; at third-month evaluation: 9.74 ± 0.2 vs 9.56 ± 0.3 mg/dl; p < 0.01). no significant differences were found between groups in terms of pth and magnesium levels. in all evaluation times, although urinary calcium excretion was higher in as patients with urolithiasis than in those without, it did not reach a statistical significance. iga levels were significantly higher in renal stone sufferers than hc patients in all evaluation times.as patients with urolithiasis also had high iga levels compared with as patients without renal stone at the second-month evaluation time (276 ± 102 vs 219 ± 104 mg/dl, p < 0.002). increased levels of serum calcium and iga levels as well as family history for urolithiasis may be an indicator of the development of urolithiasis in as patients.

引自：G?nüllü E, Bilge N?, Cansu DU, et al.Risk factors for urolithiasis in patients with ankylosing spondylitis: a prospective case-control study. Urolithiasis. 2016 Aug 19.