草酸钙结石患者尿液中纳米微晶的成核、生长、聚集及其与结石形成的关系

肾结石的主要组分是草酸钙(CaOxa)等晶体。目前肾结石只能在形成以后才能被诊断,这给患者带来了极大的痛苦。肾结石的形成与尿液中的纳米微晶性质密切相关,如果能在结石形成之前或形成初期早期检测,则可以有效地预防肾结石发生发展。本文结合本课题组的工作,从微晶尺寸、微晶的聚集程度、形貌、化学组分、Zeta电位和稳定性等方面综述了肾结石患者尿液中纳米微晶的性质差异及其与肾结石形成的关系,并与健康对照者进行了比较;讨论了CaOxa结石患者在服用防石药物柠檬酸钾后尿微晶的性质变化。研究结果表明尿液中的纳米微晶的聚集是导致微晶快速增大和结石形成的关键因素,说明通过调控纳米微晶的物理、化学性质,有可能抑制肾结石的形成和复发。     

服用柠檬酸钾前后草酸钙结石患者的尿微晶和尿液性质变化

采用透射电子显微镜(TEM)、扫描电子显微镜(SEM)、X射线衍射(XRD)、傅立叶变换红外光谱(FTIR)和ζ电位分析仪研究了草酸钙(CaOxa)结石患者在服用柠檬酸钾(K3cit)前后尿液中微晶的性质变化,这些性质包括:尿微晶的形貌、尺寸、聚集状态、质量、种类和ζ电位,并研究了服药前后尿液的稳定性差异和pH值变化。服用K3cit前,结石患者的尿微晶棱角尖锐,聚集明显,尺寸从几十纳米到几百微米不等,主要为一水草酸钙(COM)、尿酸等;而服用K3cit一周后,部分尿微晶的形状变得圆钝,聚集现象明显减少,平均粒径减小,部分尿微晶的表面出现凹陷,二水草酸钙(COD)和尿酸盐的百分含量增加,尿微晶的数量和种类减少,尿液pH值上升,ζ电位绝对值增加,自相关时间增加。从患者服用K3cit后引起尿pH值增加、尿液中排泄的柠檬酸和Tamm-Horsfall蛋白浓度增加、柠檬酸与Ca2+离子配位等角度,讨论了K3cit抑制CaOxa结石形成的机制。     

尿液中的纳米微晶及其与尿石形成的关系

尿石症是一种世界范围的常见病和多发病,其主要的矿物成分为草酸钙(CaOxa)等[1-2]。但至今为止,尿石症形成过程中的许多化学及物理问题尚不清楚:尿液中的微晶是怎样生长和聚集?随后又是怎样黏附到尿路细胞膜上而形成结石?正常人与尿石患者尿液中微晶的数量和尺寸等存在什么样的     

不同模拟体系中草酸钙结晶的比较研究

泌尿系结石是一种世界范围内的常见病及多发病 ,如深圳市的尿结石患病率高达 4.87%[1] ,其发病率呈上升趋势 .泌尿系结石在手术后复发率高 ,尤其是对结石的预防 ,目前尚无十分理想的方法 ,至今其形成机制未完全阐明 ,80 %以上的尿结石患者病因不清 [2 ] .草酸钙 (Ca C2 O4 )是泌尿系结石的主要成分 .体内 Ca C2 O4 结石的形成与热力学 (过饱和度 )和动力学 (成核、生长和聚集 )因素相关 .虽然在尿液中发现有二水草酸钙 (COD)晶体 ,但是热力学稳定的一水草酸钙 (COM)是尿石中最普遍的晶型[3 ] .在大多数的 Ca C2 O4 结石中 ,COM的发…     

尿液中纳米微晶的团聚促进泌尿系结石的形成

采用纳米粒度仪和透射电子显微镜(TEM)比较研究了尿石症患者与健康对照者尿液中纳米微晶的尺寸、粒度分布、聚集状态、自相关函数和ξ电位随放置时间的变化. 患者尿样放置3 h后, 其尿微晶平均粒径(D_a)由506 nm增至958 nm, 粒度分布范围变宽, 自相关时间由1.84 s延长到3.93 s, ξ电位由-1.34 mV降低至-3.89 mV; 而健康对照者尿微晶的D_a仅由330 nm增加至416 nm, 自相关时间由1.44 s延长至2.10 s, ξ电位由-8.35 mV降低至-8.90 mV. 此结果表明, 尿石症患者和健康对照者尿液中的纳米微晶不但在尺寸、粒度分布、聚集、自相关函数和ξ电位等方面存在明显的差异, 而且患者尿微晶的稳定性比对照者的差; 随着时间的延长, 患者尿液中的纳米微晶会逐渐团聚, 而对照者尿微晶的团聚要轻微得多. 从两类尿液中尿大分子和小分子抑制剂的浓度、尿微晶表面形成双电层的稳定性等方面进行了分析, 结果表明, 尿微晶的聚集是泌尿系结石生长的关键因素.     

肾上皮细胞损伤使草酸钙晶体黏附增强的分子机制

研究了非洲绿猴肾上皮细胞(Vero)在损伤前后与一水合草酸钙(COM)和二水合草酸钙(COD)晶体的黏附作用及其引起的细胞反应,探讨了肾结石形成机理.COM和COD晶体与损伤细胞的黏附加重了细胞的过氧化损伤程度,导致损伤细胞的活力进一步降低,乳酸脱氢酶(LDH)释放量和活性氧(ROS)进一步增加,坏死细胞数量进一步增多,细胞体积缩小,并出现凋亡小体.COM晶体对细胞的损伤能力显著大于COD晶体.扫描电子显微镜(SEM)观测结果表明,损伤组Vero与COM微晶的黏附作用显著强于对照组,且能促进COM微晶的聚集.共聚焦显微镜观测结果表明,Vero损伤后,其表面表达的晶体黏附分子透明质酸(HA)显著增加,HA分子是促进微晶黏附的重要原因.细胞表面草酸钙的黏附量和晶体聚集程度与细胞的损伤程度成正相关.本文结果从分子和细胞水平上提示,细胞损伤是导致草酸钙肾结石形成的重要因素.     

不同晶相草酸钙超细微晶的合成及其与硫酸软骨素A的相互作用

采用配位沉淀法制备了二水草酸钙(COD)和一水草酸钙(COM)超细微晶,其尺寸分别为150nm和320nm。通过扫描电子显微镜(SEM)、X射线衍射(XRD)、红外光谱(FTIR)、纳米粒度仪(Nano-ZS)和紫外-可见吸收光谱(UV-Vis)表征了这两种草酸钙微晶。研究了尿大分子硫酸软骨素A(C4S)对上述COM和COD微晶ξ电位、粒径、聚集程度和紫外吸光度的影响。随着cC4S从0增加到1.0g·L-1,COD微晶的ξ电位从-9.7mV减小到-46.1mV,COM微晶的ξ电位从-15.9mV减小到-49.0mV;微晶表面ξ电位变负后,有利于稳定溶液中悬浮的微晶。在水溶液中,COD和COM微晶均存在显著的聚集现象,而C4S的存在可抑制COD微晶的聚集,并在浓度为0.05g·L-1时抑制效果最好。由于尿液中存在大量草酸钙微晶,本研究有助于阐明草酸钙结石的形成机理和C4S对草酸钙结石形成的抑制作用。     

沙苑子提取液对不同体系中草酸钙晶体生长影响的研究

通过与水、氯化钠、正常人尿液体系的比较,重点研究了结石患者尿液体系中加入中药沙苑子提取液对草酸钙晶体生长的的影响,利用SEM,FTIR和XRD等测试手段对所得晶体进行表征。结果发现:在结石患者尿液体系中形成的草酸钙晶体为一水草酸钙(COM)晶体,而在这4种体系中加入沙苑子提取液后,只形成二水草酸钙(COD)晶体,表明沙苑子提取液能抑制COM晶体生长,并且随着沙苑子提取液浓度增大,抑制作用增强。沙苑子抑制草酸钙晶体生长的可能机理进行了探讨。     

玉米须提取液对尿液中草酸钙晶体形成的影响

本文采用X射线衍射(XRD)、红外光谱(FTIR)、扫描电子显微镜(SEM)等方法分析了玉米须提取液对正常人尿液中草酸钙晶体形成的影响,通过电导率法研究了草酸钙晶体生长的动力学过程,以及从生物矿化的角度对玉米须提取液影响尿液中草酸钙晶体的可能机理进行了探讨。由于玉米须提取液中有机酸或多糖的羟基、羰基等通过配位作用与Ca²⁺结合形成可溶性配位化合物,减少了Ca²⁺与Oxa^2-的结合能力,从而抑制了CaOxa的成核和生长。同时,可能由于玉米须提取液中有效成分与二水草酸钙(COD)的吸附点键合,增强了COD晶体在溶液中的热力学稳定性,进而抑制了COD晶体向热力学更稳定态的一水草酸钙(COM)晶体转变。结果显示,这种抑制作用随玉米须浓度增大而增大,且COD晶体尺寸随着玉米须浓度的增大而减小。玉米须抑制COD晶体向COM晶体转变的作用为开发预防和治疗尿结石的药物提供了启示。     

海藻硫酸多糖抑制草酸钙结石形成的化学模拟

用体外模拟方法研究了从海藻异枝麒麟菜中提取的硫酸多糖(ESPS)对尿结石患者尿液中草酸钙晶体生长的影响. ESPS不但诱导与尿路细胞膜粘附力较弱的二水草酸钙晶体形成, 而且抑制一水草酸钙的生长和聚集, 归因于一水草酸钙的富钙(101)晶面与聚阴离子ESPS之间的静电相互作用. 上述结果表明, ESPS是一种抑制草酸钙结石的潜在绿色药物.     

Inhibition of the Crystal Growth and Aggregation of Calcium Oxalate by Algae Sulfated Polysaccharide In-vitro

Kidney stone disease causes substantial suffering and occasional renal failure. The content of calcium oxalate (CaOxa) is up to 70-80% in the stones1,2. However, the mechanism of the formation of urinary stones is not yet clearly understood and the questi…     

Analysis of calcium, oxalate, and citrate interaction in idiopathic calcium urolithiasis in children

The majority of urinary stones in children are composed of calcium oxalate. To investigate the interaction between urinary calcium, oxalate, and citrate as major risk factors for calcium stones formation, their 24-h urinary excretion was determined in 30 children with urolithiasis and 15 normal healthy children. The cutoff points between children with urolithiasis and healthy children, accuracy, sensitivity, and specificity for each risk factor alone as well as for all three taken together were determined. OneR and J4.8 classifiers as parts of the larger data mining software Weka, based on machine learning algorithms, were used for the determination of the cutoff points for differentiation of the children. The decision tree based on J4.8 classifier analysis of all three risk factors together proved to be the best for differentiating stone formers from normal children. In comparison to the accuracy of the differentiation after calcium and oxalate of 80% and 75.6%, respectively, the decision tree showed an accuracy of 97.8%. Even when its stability was tested by the leave-one-out cross-validation procedure, the accuracy remained at a very acceptable percentage of 93.2% correctly classified patients. J4.8 classifier analysis gave a look inside urinary calcium, oxalate, and citrate interaction. Urinary calcium excretion was shown as the most informative in discrimination of the children with urolithiasis from healthy children. However, it was shown that oxalate and citrate excretions might influence the stone formation in a subpopulation of the stone formers. In patients with low urinary calcium, a major role in lithogenesis belongs to oxalate, in some of them alone and in others in conjunction with citrate. Decreased urinary citrate excretion in the presence of increased oxalate excretion may lead to stone formation.     

Thermal, UV, FTIR, and XRD studies of urinary stones

Various crystals are seen in human urine. Oxalate, Phosphate, Uric acid, and Urate crystals are generally seen in urinary calculi. Calcium stones are most common, comprising 75 % of all urinary calculi. They may be pure calcium oxalate or calcium phosphate or a mixture of both. Many stones are not homogeneous. Low calcium intake increases the intestinal absorption of calcium, thus decreasing the amount of calcium available in the intestinal tract to form insoluble complexes with Oxalate. Consequently, a higher amount of oxalate is available for intestinal absorption and as a result, urinary oxalate excretion increases. Mineral water consumption did not reduce urinary oxalate excretion. High urinary excretion and concentration of magnesium decrease both the nucleation and growth rates of calcium oxalate crystals in urine, because of the higher solubility of magnesium oxalate compared with calcium oxalate. Analytical results show calcium oxalate to be one of the major inorganic components of renal stones and found to be present in almost all kidney and bladder stones. About 39.5 % of the total composition of the calculi is found to contain purely calcium oxalate and also hydroxyl apatite. The ten samples are a mixture of calcium oxalate and phosphate stones. Four samples are calcium oxalate as major composition and the remaining are calcium phosphate as major composition. These kidney stones are taken photographically and size of the stone are measured using optical microscopy. These qualitative analyses are also confirmed by UV, FTIR, DSC, and XRD analysis.     

植物药抑制泌尿系结石形成的化学基础

植物药治疗泌尿系结石具有独特的疗效.本文综述了国内外植物药(泽泻,Phyllanthus niruri,Zeamays,Agropyron repens和Herniaria hirsute等)在体外模拟实验和动物实验中对泌尿系结石形成的影响,植物药抑制泌尿系结石形成的机制和化学基础是:植物药与钙离子发生配位,降低尿石盐的过饱和度;抑制一水草酸钙生长,诱导二水草酸钙形成;抑制晶体生长和聚集;可以保护尿路粘膜,防止晶体在肾上皮细胞上发生粘附;改变尿石形成促进剂和抑制剂的排泄量.     

石质文物表面生物矿化保护材料的仿生制备

许多濒危石质文物急需进行保护处理. 但是, 调查表明已经使用过的表面防护材料很难令人满意, 探索新的石质文物保护材料已是当务之急. 本工作以石质文物表面天然生成的生物矿化膜为仿生合成目标, 依据生物矿化的原理, 以硫酸软骨素作为有机模板, 草酸钙的亚稳过饱和溶液作为无机前驱物, 室温下在石材表面仿生合成了主要成分为一水草酸钙的无机表面保护材料. 其制备工艺用正交试验进行了优化; 结构和形貌用X射线衍射分析仪和原子力显微镜进行了表征; 通过憎水性、耐污性和耐酸性试验进行了合成膜的保护性能测试, 效果良好. 本方法为开拓新的石质文物保护材料提供了思路.     

Analysis of urinary stone constituents using powder X-ray diffraction and FT-IR

Constituents of urinary stones obtained from various patients from western part of India, which is a highly urinary stone disease-prone area, have been analysed. Eight stones from four patients were collected through urologists and have been analysed using powder X-ray diffraction and FT-IR. Thermogravimetric analysis (TGA) and scanning electron microscopic (SEM) image of selected samples were also carried out. The analysis revealed that calcium oxalate monohydrate, which is also known as whewellite, is the common constituent of all of the stones, particularly at the initial stage of stone formation. However, multi phases viz. whewellite phase, and hydroxyl and carbonate apatite phases are also detected in the case of third and fourth patients, from where multiple stones were obtained. Interestingly, in these mixed phase stones the concentration of whewellite decreases with increasing the concentration of apatite phases. Thermal behaviour of the whewellite phase was studied by TGA and variable temperature XRD analysis. Morphology of the whewellite and apatite phases, examined by SEM image, has also been reported.     

Adhesion between molecules and calcium oxalate crystals: critical interactions in kidney stone formation

Kidney stones are crystal aggregates, most commonly containing calcium oxalate monohydrate (COM) crystals as the primary constituent. Notably, in vitro studies have suggested that anionic molecules or macromolecules with substantial anionic functionality (e.g., carboxylate) play an important role in crystal aggregation and crystal attachment to renal epithelial cells. Furthermore, kidney stones contain measurable amounts of carboxylate-rich proteins that may serve as adhesives and promote aggregation of COM crystals. Atomic force microscopy (AFM) measurements of adhesion forces between tip-immobilized molecules and the COM (100) surface in aqueous media, described herein, reveal the effect of functional groups on adhesion and support an important role for the carboxylate group in processes responsible for kidney stone formation, specifically macromolecule-mediated adhesion of COM crystals to cells and crystal aggregation. The presence of poly(aspartic acid) during force measurements results in a reduction in the adhesion force measured for carboxylate-modified tips, consistent with the blocking of binding sites on the COM (100) surface by the carboxylate-rich polymer. This competitive binding behavior mimics the known reduction in attachment of COM crystals to renal epithelial cells in the presence of carboxylate-rich urinary macromolecules. These results suggest a feasible methodology for identifying the most important crystal surface-macromolecule combinations related to stone formation.     

酒石酸及其盐抑制泌尿系结石的化学基础

本文探讨了酒石酸及其盐对泌尿系结石形成、抑制和治疗的化学基础，重点讨论了其与钙离子的螯合，诱导二水草酸钙和三水草酸钙形成、减少晶体滞留，影响CaOxa晶体的晶面与形貌，抑制尿石矿物的成核、生长和聚集，调节新陈代谢、减小尿石形成的几率，并讨论了抗衡阳离子对其抑制能力的影响。     

海藻异枝麒麟菜多糖抑制尿石盐草酸钙晶体生长的研究

采用扫描电子显微镜(SEM)、 红外光谱(FTIR)和X射线衍射(XRD)方法研究了从海藻异枝麒麟菜中提取的硫酸多糖(ESPS)对草酸钙(CaOxa)晶体生长的影响. 结果表明, 添加ESPS能抑制一水草酸钙(COM)的生长, 同时诱导二水草酸钙(COD)晶体的形成. 随着ESPS的质量浓度从0增加到0.03和0.50 mg/mL, COD的质量分数从0分别增加到10%和55%; COM的(1 01)晶面加强, (020)晶面减弱直至消失, 并从三维晶体转变为棱角圆顿的四角形片状晶体; COM和COD的尺寸均明显变小. 这些结果表明, ESPS是抑制CaOxa结石形成的一种潜在药物.