Fogazzi G B
Divisione di Nefrologia e Dialisi, Ospedale Maggiore, IRCCS, Milan, Italy.
Nephrol Dial Transplant. 1996 Feb;11(2):379-87. doi: 10.1093/oxfordjournals.ndt.a027276.
Crystalluria is a frequent finding in the routine examination of urine sediments. In most instances the precipitation of crystals of calcium oxalate, uric acid triple phosphate, calcium phosphate and amorphous phosphates or urates is caused by transient supersaturation of the urine, ingestion of foods, or by changes of urine temperature and/or pH which occur upon standing after micturition. In a minority of cases, however, crystalluria is associated with pathological conditions such as urolithiasis, acute uric acid nephropathy, ethylene glycol poisoning, hypereosinophilic syndrome. In addition, crystalluria can be due to drugs such as sulphadiazine, acyclovir, triamterene, piridoxylate, primidone, which under the influence of various factors can crystallize within the tubular lumina and cause renal damage. In all these instances the study of crystalluria is diagnostically useful and is also important to follow the course of the disease. However, a proper methodological approach is necessary. This includes the handling of freshly voided urine, the knowledge of the urinary pH, and the use of a contrast phase microscope equipped with polarizing filters.
结晶尿是尿液沉渣常规检查中常见的发现。在大多数情况下，草酸钙、尿酸三磷酸盐、磷酸钙以及无定形磷酸盐或尿酸盐结晶的析出是由尿液短暂的过饱和、食物摄入，或排尿后静置时尿液温度和/或pH值的变化引起的。然而，在少数情况下，结晶尿与诸如尿路结石、急性尿酸肾病、乙二醇中毒、嗜酸性粒细胞增多综合征等病理状况相关。此外，结晶尿可能由磺胺嘧啶、阿昔洛韦、氨苯蝶啶、吡哆醛、扑米酮等药物引起，这些药物在各种因素的影响下可在肾小管腔内结晶并导致肾损伤。在所有这些情况下，对结晶尿的研究在诊断上是有用的，对跟踪疾病进程也很重要。然而，需要一种适当的方法学途径。这包括对新鲜排出尿液的处理、对尿液pH值的了解，以及使用配备偏振滤光片的相差显微镜。
