Endoscopic evidence of calculus attachment to Randall's plaque
Endoscopic evidence of calculus attachment to Randall's plaque
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DOI：
10.1016/s0022-5347(05)01017-7
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发表时间：
2006-05-01
影响因子：
6.6
通讯作者：
Lingeman, JE
中科院分区：
文献类型：
--
作者：
Matlaga, BR;Williams, JC;Lingeman, JE
目的：草酸钙结石开始是附着在肾乳头Randall氏斑块处的小结石。然而，没有研究调查过草酸钙结石形成者附着结石的患病率或结石附着部位与兰德尔斑块之间的关系。在这项研究中，我们采用内镜检查肾乳头结石患者接受经皮肾镜取石术调查这两个问题。材料和方法：特发性草酸钙结石患者接受PNL取石纳入本研究。检查多个乳头，并通过数字视频记录图像。结果：23例患者共检查了24个肾脏和172个肾乳头，其中11例为肾乳头结石。所有患者的肾脏均有乳头状斑块，其中11例患者有结石附着。大多数乳头（91%）含有斑块。结论：草酸钙结石形成者中附着结石的患病率（48%）高于之前报道的一般人群的患病率。兰德尔的牌匾上有附件附着结石的高患病率和附着部位的出现与草酸钙结石形成的机制一致，其中结石开始为斑块过度生长。
Purpose: It has been proposed that calcium oxalate calculi begin as small stones attached to the renal papillae at sites of Randall's plaque. However, no study has investigated the prevalence of attached stones in calcium oxalate stone formers or the relationship between stone attachment site and Randall's plaque. In this study we used endoscopic examination of renal papillae in stone formers undergoing percutaneous nephrolithotomy to investigate both issues.Materials and Methods: Idiopathic calcium oxalate stone formers undergoing PNL for stone removal were enrolled in this study. Multiple papillae were examined and images were recorded by digital video. The presence or absence of papillary plaque and attached stones was noted, as was the site of stone attachment.Results: In 23 patients, 24 kidneys and 172 renal papillae were examined. All kidneys were found to have papillary plaque and 11 of the patients had attached stones. Most papillae (91%) contained plaque.Conclusions: The prevalence of attached stones in calcium oxalate stone formers (48%) is greater than that previously reported for the general population. Attachment appears to be on Randall's plaque. The high prevalence of attached stones and the appearance of the attachment site are consistent with a mechanism of calcium oxalate stone formation in which stones begin as plaque overgrowth.