Cheng P T, Reid A, Millard J, Pritzker K P, Khanna R, Oreopoulos D G
Scan Electron Microsc. 1983(Pt 4):1939-46.
Patients on haemodialysis or peritoneal dialysis due to renal failure have an unusually high incidence of kidney stones (from 5 to 51% depending on methodology). However, there is a controversy on the composition of these stones - whether they are calcium oxalate stones or matrix stones. This paper presents ultrastructural evidence that these stones are in fact heterogeneous, ranging from calcium oxalate stones with little organic matrix component, through calcium oxalate and calcium apatite stones with substantial organic matrix component, to matrix stones with little inorganic material component. The correlative analytical methodology developed in this laboratory employing analytical scanning and transmission electron microscopy, electron and x-ray diffraction, as well as biochemistry, was reported previously. For the calcium oxalate stones, scanning electron microscopy showed that numerous small crystals of 1-3 micron in size were exposed to stone surfaces, apparently in an unorganized manner. However, transmission electron microscopy sections showed orderly stacking of crystals held together by organic matrix, just like bricks held together by mortar. For the matrix stones, scanning electron microscopy showed smooth stone surfaces while transmission electron microscopy sections showed focal areas of calcium oxalate or apatite deposits as identified by selected area electron diffraction.
因肾衰竭接受血液透析或腹膜透析的患者肾结石发病率异常高（根据方法不同，发病率在5%至51%之间）。然而，这些结石的成分存在争议——它们是草酸钙结石还是基质结石。本文提供了超微结构证据，表明这些结石实际上是异质的，从有机基质成分很少的草酸钙结石，到有机基质成分大量的草酸钙和磷灰石结石，再到无机物质成分很少的基质结石。本实验室开发的采用分析扫描和透射电子显微镜、电子和X射线衍射以及生物化学的相关分析方法，此前已有报道。对于草酸钙结石，扫描电子显微镜显示许多大小为1 - 3微米的小晶体暴露在结石表面，显然排列无序。然而，透射电子显微镜切片显示晶体由有机基质有序堆叠在一起，就像用灰浆粘在一起的砖块。对于基质结石，扫描电子显微镜显示结石表面光滑，而透射电子显微镜切片显示通过选区电子衍射鉴定出的草酸钙或磷灰石沉积的局部区域。
