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傅里叶变换红外光谱法分析肾结石。

Fourier transform infrared spectroscopy for analysis of kidney stones.

机构信息

Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan.

Department of Surgery, Aga Khan University, Karachi, Pakistan.

出版信息

Investig Clin Urol. 2018 Jan;59(1):32-37. doi: 10.4111/icu.2018.59.1.32. Epub 2018 Jan 3.

Abstract

PURPOSE

To compare the results of a chemical method of kidney stone analysis with the results of Fourier transform infrared (FT-IR) spectroscopy.

MATERIALS AND METHODS

Kidney stones collected between June and October 2015 were simultaneously analyzed by chemical and FT-IR methods.

RESULTS

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.

CONCLUSIONS

FT-IR analysis of kidney stones can overcome many limitations associated with chemical analysis.

摘要

目的

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。

材料与方法

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。

结果

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。

结论

FT-IR 分析肾结石可克服化学分析的许多局限性。

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本文引用的文献

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EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis.EAU 指南:尿石症的诊断和保守治疗管理。
Eur Urol. 2016 Mar;69(3):468-74. doi: 10.1016/j.eururo.2015.07.040. Epub 2015 Aug 28.
5
FT-IR spectral studies on certain human urinary stones in the patients of rural area.FT-IR 光谱研究农村地区患者的某些人尿结石。
Spectrochim Acta A Mol Biomol Spectrosc. 2012 Jul;93:260-5. doi: 10.1016/j.saa.2012.03.028. Epub 2012 Mar 17.
9
Nephrolithiasis as a systemic disorder.肾结石作为一种全身性疾病。
Curr Opin Nephrol Hypertens. 2008 May;17(3):304-9. doi: 10.1097/MNH.0b013e3282f8b34d.

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