Buchholz N P, Kim D S, Grover P K, Ryall R L
Department of Surgery, Flinders Medical Centre, Bedford Park, Australia.
Scanning Microsc. 1996;10(2):435-42; discussion 442-4.
This study aimed to compare calcium oxalate (CaOx) crystallization in undiluted urine from healthy men and women with the object of clarifying the difference in stone incidence between the two sexes. Twenty-four hour urine specimens were collected from 37 men and 28 women. Urinary pH, and concentrations of Ca, oxalate and urate were measured, and indices of crystallization determined by Coulter Counter particle analysis following induction of CaOx crystallization by addition of oxalate. The amount of oxalate required to induce crystallization was significantly (p < 0.01) higher in females than in males, as was the overall particle volume deposited after 90 minutes incubation (p < 0.006). Scanning electron microscopy revealed larger individual crystals in female urine, and a greater degree of crystal aggregation in male urine, although the average overall size of the precipitated crystal particles did not differ between the two sexes. There were no significant differences between men and women with regard to median pH, or Ca and oxalate concentrations, but the median urate concentrations were slightly, but significantly, higher (p < 0.05) in the women's urines than in the men's. It was concluded that the greater risk of CaOx stones in men is related to an increased propensity to nucleate CaOx crystals per se, rather than to a tendency to form larger crystalline particles.
本研究旨在比较健康男性和女性未稀释尿液中草酸钙（CaOx）的结晶情况，以明确两性结石发病率的差异。收集了37名男性和28名女性的24小时尿液样本。测量了尿液pH值、钙、草酸盐和尿酸盐浓度，并在加入草酸盐诱导CaOx结晶后，通过库尔特计数器颗粒分析确定结晶指数。诱导结晶所需的草酸盐量在女性中显著高于男性（p < 0.01），90分钟孵育后沉积的总体颗粒体积也是如此（p < 0.006）。扫描电子显微镜显示，女性尿液中的单个晶体较大，男性尿液中的晶体聚集程度更高，尽管沉淀晶体颗粒的平均总体大小在两性之间没有差异。男性和女性在中位pH值、钙和草酸盐浓度方面没有显著差异，但女性尿液中的中位尿酸盐浓度略高且具有显著差异（p < 0.05）。研究得出结论，男性患CaOx结石的风险更高与CaOx晶体本身成核倾向增加有关，而不是与形成更大结晶颗粒的倾向有关。
