Porhanov V A, Medvedev V L, Budanov A A, Kurzanov A N, Basov A A
Kuban State Medical University, Krasnodar, Russia.
Scientific Research Institute Ochapovsky Regional Clinical Hospital #1, Krasnodar, Russia.
Urologiia. 2021 Mar(1):60-65.
THE AIM OF THE RESEARCH: to reveal the relationship of various markers of calcium metabolism (osteopontin (OPN), parathyroid hormone-related protein (PTHrP), vitamin D, parathyroid hormone (PTH)) on the course of urolithiasis (Urolithiasis) in patients with calcium oxalate nephrolithiasis.
100 people were examined, the following groups were included: group 1 - patients with calcium oxalate primary nephrolithiasis (n=41), group 2 - with calcium oxalate recurrent nephrolithiasis (n=39). Group 3 included conditionally healthy volunteers (n=20). The studies were carried out by the immunoenzymometric ELIZA and biochemical methods using appropriate test systems.
in patients with recurrent nephrolithiasis, the serum PTHrP level is 54.6 (25.4-78.2) pg / ml, which is 3.7 times higher than in conventionally healthy individuals; the level of osteopontin is more than 1.5 times higher and amounts to 1.820 (0.991-2.212) pg / ml. In the group of primary nephrolithiasis, the level of PTHrP is 2-2.5 times higher than in conventionally healthy people. In patients with primary nephrolithiasis, the blood calcium level does not correlate with the level of PTHrP in the blood (r=- 0.0173, p> 0.05), as in the group with recurrent nephrolithiasis (r=0.0223, p>0.05).
in patients with recurrent nephrolithiasis in the preoperative period, the serum levels of osteopontin and PTHrP in the blood serum were higher than in patients who were first diagnosed with urolithiasis, the data obtained can be used as a criterion for predicting the risk of recurrence of urolithiasis in the postoperative period. The blood calcium level does not have a statistically significant relationship with PTHrP, which allows us to assume that PTHrP has other mechanisms of influence on the development of urolithiasis, given the data obtained that the PTHrP level in patients with primary and recurrent nephrolithiasis is higher than in conditionally healthy people.
Determination of the level of PTHrP and osteopontin in patients with urolithiasis allows predicting the risk of recurrence of urolithiasis at the stage of primary calcium oxalate nephrolithiasis. Determination of the level of PTHrP makes it possible to predict the risks of developing urolithiasis in conventionally healthy individuals, which can be used for targeted prevention of an unfavorable course of urolithiasis by prescribing timely adequate rational therapy and correcting the patients diet. At the same time, no correlation was found between the level of PTHrP and the level of blood calcium in patients with calcium oxalate nephrolithiasis; therefore, further studies of the role of this protein in the pathogenesis of urolithiasis are needed.
研究目的：揭示草酸钙肾结石患者尿石症病程中钙代谢的各种标志物（骨桥蛋白（OPN）、甲状旁腺激素相关蛋白（PTHrP）、维生素D、甲状旁腺激素（PTH））之间的关系。
对100人进行了检查，包括以下几组：第1组 - 原发性草酸钙肾结石患者（n = 41），第2组 - 复发性草酸钙肾结石患者（n = 39）。第3组包括条件健康志愿者（n = 20）。研究采用免疫酶联免疫吸附测定法（ELISA）和生化方法，使用适当的检测系统进行。
在复发性肾结石患者中，血清PTHrP水平为54.6（25.4 - 78.2）pg/ml，比传统健康个体高3.7倍；骨桥蛋白水平高出1.5倍以上，达到1.820（0.991 - 2.212）pg/ml。在原发性肾结石组中，PTHrP水平比传统健康人群高2 - 2.5倍。在原发性肾结石患者中，血钙水平与血液中PTHrP水平无相关性（r = -0.0173，p>0.05），复发性肾结石组也是如此（r = 0.0223，p>0.05）。
在复发性肾结石患者术前，血清中骨桥蛋白和PTHrP水平高于首次诊断为尿石症的患者，所得数据可作为预测术后尿石症复发风险的标准。血钙水平与PTHrP无统计学显著关系，鉴于原发性和复发性肾结石患者的PTHrP水平高于条件健康人群，这使我们假设PTHrP对尿石症发展有其他影响机制。
测定尿石症患者的PTHrP和骨桥蛋白水平可预测原发性草酸钙肾结石阶段尿石症复发的风险。测定PTHrP水平可预测传统健康个体发生尿石症风险，通过及时给予适当合理治疗和纠正患者饮食，可用于针对性预防尿石症不利病程。同时，草酸钙肾结石患者中PTHrP水平与血钙水平无相关性；因此，需要进一步研究该蛋白在尿石症发病机制中的作用。
