Herrmann U, Schwille P O
Department of Surgery, University of Erlangen, FRG.
Urol Res. 1992;20(2):157-64. doi: 10.1007/BF00296529.
A retrospective study was done on the nature and degree of crystalluria in fasting and postprandial urine in patients with recurrent idiopathic calcium urolithiasis (RCU) for whom stone analysis was available. RCU was stratified into subgroups in accordance with stone analysis. The crystals were obtained and identified using a filter technique and polarization microscopy, respectively. Crystalluria score, relative saturation products (RSPs), and low-molecular-weight inhibitors were assessed. Calcium oxalate crystals were never observed in either male or female patients with stones composed exclusively of calcium oxalate, and only sporadically in patients with mixed stones (the additional component was calcium phosphate in most cases). Other crystalluria phases, such as amorphous calcium phosphate, a urate-containing phase, and a phase presenting as spherolytic particles, were slightly more frequent in patients with mixed stones. In contrast to crystalluria, RSPs and inhibitors differed in male and female patients, suggesting that crystalluria may not be under the exclusive control of these factors. The following conclusions were reached. (1) Calcium oxalate crystalluria is absent from RCU with pure calcium oxalate stones; hence, calcium oxalate crystalluria does not qualify as a diagnostic aid. (2) The co-existence of the isotropic phase and mixed stones may indicate that the formation of these concretions is characteristic for a major RCU subgroup. (3) On the basis of clinical chemistry and physicochemical data in urine and of crystalluria, it appears that the pathogenesis of RCU differs in male and female subjects.
对有结石分析结果的复发性特发性钙尿路结石（RCU）患者的空腹和餐后尿液中的结晶尿性质及程度进行了回顾性研究。根据结石分析结果将RCU分为亚组。分别使用过滤技术和偏光显微镜获取并鉴定晶体。评估结晶尿评分、相对饱和产物（RSPs）和低分子量抑制剂。在仅由草酸钙组成结石的男性或女性患者中从未观察到草酸钙晶体，在混合结石患者中仅偶尔观察到（大多数情况下额外成分是磷酸钙）。其他结晶尿阶段，如无定形磷酸钙、含尿酸盐阶段和呈现为球解颗粒的阶段，在混合结石患者中略为常见。与结晶尿不同，RSPs和抑制剂在男性和女性患者中存在差异，这表明结晶尿可能并非仅受这些因素控制。得出以下结论。（1）纯草酸钙结石的RCU不存在草酸钙结晶尿；因此，草酸钙结晶尿不能作为一种诊断辅助手段。（2）各向同性阶段与混合结石的共存可能表明这些结石的形成是主要RCU亚组的特征。（3）根据尿液中的临床化学和物理化学数据以及结晶尿情况，似乎RCU的发病机制在男性和女性受试者中有所不同。
