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[尿结石的化学成分、结构特征及其在莫斯科市、柏林市和吉尔吉斯苏维埃社会主义共和国的患病率]

[The characteristics of the chemical composition and structure of urinary stones and their prevalence in the cities of Moscow, Berlin and of the Kirghiz SSR].

作者信息

Schubert G, Chudnovskaia M V, Brien G, Tynaliev M T, Popovkin N N, Timin A R

出版信息

Urol Nefrol (Mosk). 1990 Sep-Oct(5):49-54.

PMID:2148236
Abstract

The authors studied the features of urolithiasis in three different geographical regions: Moscow, the Kirghiz SSR, and Berlin from the findings of examination of the composition and structure of uroliths removed by operation or passed spontaneously, (602 concrements from Moscow, 10,000 from Berlin, and 127 from Kirghizia). X-ray diffraction measurement, infrared spectrophotometry, and polarizing microscopy were conducted to analyze the composition and structure of the stones. Complex biochemical examination was carried out in patients from Moscow and Kirghizia. According to the results of the study, the following features of urolithiasis are common in the studied regions: (1) prevalence of oxalate lithiasis on the whole, which points to the principal role of metabolic factors in lithogenesis; (2) approximately similar amounts of apatite carbonate crystals in the uroliths; (3) certain similarity in composition of concrements from Berlin and Kirghizia. The most essential differences are: (1) the frequency of renal oxalate stones is highest in Berlin and lowest in Moscow. The prevalent types of calcium oxalate stones are: whewellite of concentric structure (linked with hyperuricemia) in Kirghizia; whewellite of small randomly orientated crystals (linked with hypercalciuria) and stones with signs of transformation of weddellite to whewellite in Moscow; (2) lesser distribution of phosphate lithiasis in Berlin than in Kirghizia and particularly in Moscow. Prevalence of struvite crystals in stones from Moscow, the formation of which is linked with the vital activity of Proteus and E. coli; (3) higher distribution of urate lithiasis in Moscow and particularly in Kirghizia where significant metabolic risk factors of lithogenesis were revealed.

摘要

作者根据通过手术取出或自行排出的尿石的成分和结构检查结果,研究了三个不同地理区域(莫斯科、吉尔吉斯苏维埃社会主义共和国和柏林)的尿石症特征(来自莫斯科的602块结石、来自柏林的10000块结石和来自吉尔吉斯斯坦的127块结石)。进行了X射线衍射测量、红外分光光度法和偏光显微镜检查以分析结石的成分和结构。对来自莫斯科和吉尔吉斯斯坦的患者进行了综合生化检查。根据研究结果,尿石症在这些研究区域具有以下共同特征:(1)总体上草酸钙结石患病率较高,这表明代谢因素在结石形成中起主要作用;(2)尿石中磷灰石碳酸盐晶体的数量大致相似;(3)来自柏林和吉尔吉斯斯坦的结石成分有一定相似性。最主要的差异在于:(1)肾草酸钙结石的发生率在柏林最高,在莫斯科最低。草酸钙结石的常见类型为:吉尔吉斯斯坦的同心结构水草酸钙(与高尿酸血症有关);莫斯科的小随机取向晶体水草酸钙(与高钙尿症有关)以及有从二水草酸钙向水草酸钙转变迹象的结石;(2)磷酸盐结石在柏林的分布少于吉尔吉斯斯坦,尤其是少于莫斯科。莫斯科结石中鸟粪石晶体的患病率较高,其形成与变形杆菌和大肠杆菌的活性有关;(3)尿酸盐结石在莫斯科尤其是吉尔吉斯斯坦分布较高,在吉尔吉斯斯坦发现了结石形成的重要代谢风险因素。

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