尿酸在不同类型草酸钙肾结石中的作用。

Role of uric acid in different types of calcium oxalate renal calculi.

作者信息

Grases Félix, Sanchis Pilar, Perelló Joan, Costa-Bauzá Antonia

机构信息

Laboratory of Renal Lithiasis Research, Institute of Health Sciences Research (IUNICS), University of Balearic Islands, Mallorca, Spain.

出版信息

Int J Urol. 2006 Mar;13(3):252-6. doi: 10.1111/j.1442-2042.2006.01262.x.

DOI:10.1111/j.1442-2042.2006.01262.x

PMID:16643619

Abstract

AIM

The presence of uric acid in the beginning zone of different types of 'pure' calcium oxalate renal calculi was evaluated with the aim of establishing the degree of participation of uric acid crystals in the formation of such calculi.

METHODS

The core or fragment of different types of 'pure' calcium oxalate renal calculi was detached, pulverized and uric acid extracted. Uric acid was determined using a high-performance liquid chromatography/mass spectrometry method.

RESULTS

In calcium oxalate monohydrate (COM) papillary calculi with a core constituted by COM crystals and organic matter, 0.030+/-0.007% uric acid was found in the core. In COM papillary calculi with a core constituted by hydroxyapatite, 0.031+/-0.008% uric acid was found in the core. In COM unattached calculi (formed in renal cavities) with the core mainly formed by COM crystals and organic matter, 0.24+/-0.09% uric acid was found in the core. In COM unattached calculi with the core formed by uric acid identifiable by scanning electron microscopy (SEM) coupled to X-ray microanalysis, 20.8+/-7.8% uric acid was found in the core. In calcium oxalate dihydrate (COD) unattached calculi containing little amounts of organic matter, 0.012+/-0.004% uric acid was found. In COD unattached calculi containing little amounts of organic matter and hydroxyapatite, 0.0030+/-0.0004% of uric acid was found.

CONCLUSIONS

From these results it can be deduced that uric acid can play an important role as inducer (heterogeneous nucleant) of COM unattached calculi with the core formed by uric acid identifiable by SEM coupled to X-ray microanalysis (these calculi constitute the 1.2% of all calculi) and in COM unattached calculi with the core mainly formed by COM crystals and organic matter (these calculi constitute the 10.8% of all calculi).

摘要

目的

评估不同类型“纯”草酸钙肾结石起始区域中尿酸的存在情况，以确定尿酸晶体在这类结石形成过程中的参与程度。

方法

分离不同类型“纯”草酸钙肾结石的核心或碎片，粉碎后提取尿酸。采用高效液相色谱/质谱法测定尿酸。

结果

在以一水草酸钙（COM）晶体和有机物为核心的COM乳头状结石中，核心部位尿酸含量为0.030±0.007%。在以羟基磷灰石为核心的COM乳头状结石中，核心部位尿酸含量为0.031±0.008%。在肾腔内形成的、核心主要由COM晶体和有机物构成的游离COM结石中，核心部位尿酸含量为0.24±0.09%。在通过扫描电子显微镜（SEM）结合X射线微分析可鉴定核心由尿酸构成的游离COM结石中，核心部位尿酸含量为20.8±7.8%。在含有少量有机物的二水草酸钙（COD）游离结石中，尿酸含量为0.012±0.004%。在含有少量有机物和羟基磷灰石的COD游离结石中，尿酸含量为0.0030±0.0004%。