8例原發性副甲狀腺功能亢進症之尿路結石病患，其中12位(42.9％)是單一結石，11位(39.3％)是多發性結石，只有5位(17.8％)是華麗型結石(包括鹿角狀結石或腎鈣質沈著病)。結石分析顯示20位(71.4％)是草酸鈣與磷酸鈣，7位(25％)是草酸鈣，1位(3.6％)是磷酸鈣。我們發現原發性副甲狀腺功能亢進症之尿路結石病患其結石之形態與成份與一般自發性含鈣結石病患無顯著不同。在不同測量副甲狀腺功能之生化檢查當中，以血清總鈣量、血清游離鈣和Osteocalcin之敏感度100％最高，其次依序為PTH MM 96.4％，In-tact PTH 92.9％，24小時尿鈣排泄量42.9％，抑鈣素21.4％，血清磷17.9％，C-teminal PTH 14.3％，plasma cyclic AMP 0％。所有原發性副甲狀腺功能亢進症病人在接受副甲狀腺瘤切除手術後，血鈣皆恢復正常；並且在6至36個月追蹤檢查期間只有一位同時合併有尿枸櫞酸過少症之患者有復發性結石，其結石復發原因與副甲狀腺功能無關。我們認為所有尿路結石病患皆應接受血清鈣篩檢，因為一旦診斷是原發性副甲狀腺功能亢進症，副甲狀腺切除術將可獲致極佳之療效。

The biochemical tests and radiological features of twenty eight primary hyper-parathyroid stone patients were reviewed. Of the 28 patients, 12 (42.9%) patients had single stone, 11 (39.3%) had multiple stones, and only 5 (17.8%) had florid stones (staghorn stone or nephrocalcinosis). The stone composition of 28 primary hyper-parathyroid stone former were: mixed calcium oxalate and calcium phosphate in 30 (71.4%), pure calcium oxalate in 7 (25%), pure calcium phosphate in 1 (3.6%). Ap-parently, the stone patterns and composition of primary hyperparathyroid stone were not significantly different from idiopathic calcium stone. The sensitivity rate of different biochemical assays for diagnosis of primary hyper-parathyroidism were: 100% in serum total, free calcium and osteocalcin level, PTH MM (96.4%), intact PTH (92.9%), Chloride/phosphorus ratio (89.3%), nephrogenous cyclic AMP (42.9%), 24h urinary calcium excretion (42.9%), calcitonin (21.4%), phos-phorus (17.9%), C terminal PTH (14.3%) and plasma cyclic AMP (0%). After resection of parathyroid adenoma, all patients returned to normocalcemia. During a follow up period from 6 to 36 months, only one patient developed recurrent nephrolithiasis which aws due to concomitant hypocitraturia and had nothing to do with parathyroid hyperfunction. We concluded that serum calcium should be screened in all urolithiasis patients, and parathyroidectomy will offer greatest satisfaction in treat-ing primary hyperparathyroidism.(J Urol R.O.C., 2:372-377, 1991)