Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan.
Department of Surgery, Aga Khan University, Karachi, Pakistan.
Investig Clin Urol. 2018 Jan;59(1):32-37. doi: 10.4111/icu.2018.59.1.32. Epub 2018 Jan 3.
To compare the results of a chemical method of kidney stone analysis with the results of Fourier transform infrared (FT-IR) spectroscopy.
Kidney stones collected between June and October 2015 were simultaneously analyzed by chemical and FT-IR methods.
Kidney stones (n=449) were collected from patients from 1 to 81 years old. Most stones were from adults, with only 11.5% from children (aged 3-16 years) and 1.5% from children aged <2 years. The male to female ratio was 4.6. In adults, the calcium oxalate stone type, calcium oxalate monohydrate (COM, n=224), was the most common crystal, followed by uric acid and calcium oxalate dihydrate (COD, n=83). In children, the most frequently occurring type was predominantly COD (n=21), followed by COM (n=11), ammonium urate (n=10), carbonate apatite (n=6), uric acid (n=4), and cystine (n=1). Core composition in 22 stones showed ammonium urate (n=2), COM (n=2), and carbonate apatite (n=1) in five stones, while uric acid crystals were detected (n=13) by FT-IR. While chemical analysis identified 3 stones as uric acid and the rest as calcium oxalate only. Agreement between the two methods was moderate, with a kappa statistic of 0.57 (95% confidence interval, 0.5-0.64). Disagreement was noted in the analysis of 77 stones.
FT-IR analysis of kidney stones can overcome many limitations associated with chemical analysis.
比较结石化学分析法与傅里叶变换红外(FT-IR)光谱分析法的结石分析结果。
2015 年 6 月至 10 月间收集的肾结石同时采用化学法和 FT-IR 法进行分析。
共收集 449 例肾结石患者的结石,患者年龄 1-81 岁,其中大部分为成年人(占 98.5%),儿童(3-16 岁)和<2 岁儿童的结石分别占 11.5%和 1.5%。男女比为 4.6。在成年人中,最常见的结石类型为草酸钙一水合物(COM)结石(n=224),其次为尿酸结石和草酸钙二水合物(COD)结石(n=83)。在儿童中,最常见的类型是主要为 COD 结石(n=21),其次为 COM 结石(n=11)、尿酸铵结石(n=10)、碳酸磷灰石结石(n=6)、尿酸结石(n=4)和胱氨酸结石(n=1)。22 例结石的核心成分显示有 5 例含有尿酸铵(n=2)、COM(n=2)和碳酸磷灰石(n=1),而 FT-IR 检测到 13 例尿酸结石。化学分析仅将 3 例结石鉴定为尿酸结石,其余均鉴定为草酸钙结石。两种方法的一致性中等,kappa 统计值为 0.57(95%置信区间,0.5-0.64)。77 例结石的分析结果存在分歧。
FT-IR 分析肾结石可克服化学分析的许多局限性。