Показники уратно-оксалатного обміну в осіб з цукровим діабетом, що зазнали малоінвазивного лікування з приводу уретеролітіазу

Abstract

The aim of the study: was to study the state of urate oxalate metabolism in patients with ureterolithiasis and concomitant diabetes mellitus, who underwent various methods of minimally invasive surgical treatment of urinary stones. Materials and methods. The study involved 204 people, of which men were 130 (63.7%), women – 74 (36.3%), the average age was 34.6±5.5 years. The study groups were divided into VI clinical groups: I – individuals with diabetes and ureterolithiasis, who underwent TUCL and cytrate per os (n=57); II – persons with DM and ureterolithiasis, who were TUCL (n=44); III – persons with DM and , who were administered by the ESWL (n=32); IV – persons with ureterolithiasis without DM, who underwent TUCL (n=41); V (control 1) – of the person with diabetes, who had an independent passage of stones from the ureter (n=18); VI (control 2) – healthy volunteers, with no signs of pathology (n=12). The diagnosis of the ureterolithiasis was verified using clinico-anamnestic, laboratory and instrumental research methods according to the methabolic homeostasis protocols, before and after the disintegration of the stones by the method of transurethral contact lithotripsy (TUСL) and ESWL. Results. Analysis of the above data showed that, in the presence of ureterolithiasis, there were significant changes in diurnal pH values in the form of monotony of the curve of indicators, with a significantly high shift towards acidification. Persistently acidic urine reflects the peculiarities of the urate urolythiasis in conditions of NAM, indicates the absence of an isolated violation by acute calculous obstruction and defines this state as a bilateral process. Hypocytraturia was established in all cases of ureterolithiasis, but in the urine of people with diabetes excretion rates of citrate were as low as possible. The conclusion. In patients with diabetes mellitus and concomitant ureterolithiasis there are significant disruptions in the exchange of uric acid and oxalate, with the possibility of correction and complete restoration of urodynamics with the help of the TUСL procedure. Key words: ureterolithiasis, diabetes mellitus, urates, oxalates, minimally invasive methods of lithotripsy.