枸橼酸盐抑制泌尿系结石形成的化学基础

本文综述了防石药物枸橼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配位、封闭尿石矿物生长活性位点、抑制草酸钙的成核和生长、增加尿液中尿大分子和枸橼酸浓度、改变尿液pH以及诱导二水草酸钙和三水草酸钙形成，并讨论了抗衡阳离子对枸橼酸盐抑制能力的影响。     

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。     

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…     

粘液素对草酸钙晶体生长的影响

泌尿系结石是一种常见疾病。在70％以上的结石中,草酸钙(CaOxa)单独或和其它钙盐共同为主要成分。一般认为正常人不形成尿石是其尿液中存在的抑制剂抑制了CaOxa晶体的成核、生长、聚集或固相转化。     

聚合物与草酸钙相互作用的研究进展及其对预防尿路结石的意义

聚合物对泌尿系结石的形成具有抑制和促进双重作用。本文综述了聚合物对尿石矿物草酸钙成核、生长、聚集及其与尿路细胞膜黏附影响的研究进展,讨论了聚合物影响草酸钙晶面和形貌的机理,指出了该领域所面临的问题和将来的发展方向。     

用傅立叶红外光谱测定泌尿系结石中的草酸钙

对泌尿系结石的组成进行结构分析,为分析结石病的产生原因及预防复发提供参考,在临床诊断和治疗上具有重要意义.傅立叶红外光谱是研究泌尿系结石构造的一种较理想的分析手段.用红外光谱仪定量分析泌尿结石中草酸钙采用的内标法、吸光度比值法和一阶导数法进行了比较,建立的分析方法可以简便对草酸钙混合结石中一水草酸钙(COM)和二水草酸钙(COD)进行定量测定,分析结果可初步满足临床诊断的要求.     

二水草酸钙的形成及其对尿路结石的防治

二水草酸钙(COD)是泌尿系结石的主要成分之一,其成核、生长和聚集过程与尿石的形成密切相关。本文结合我们近年来的工作,综述了生物膜及其模拟膜对COD的调控作用,尿大分子、焦磷酸盐、多磷酸盐、柠檬酸、酒石酸及表面活性剂等尿小分子的诱导作用,过饱和度、化学计量条件、pH值、离子强度、温度等体系参数对COD形成的影响;讨论了COD的形貌、晶面电荷及其与细胞膜粘附的研究进展。从临床上预防和治疗草酸钙结石的角度,综述了有利于COD形成的因素。     

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。     

凝胶体系中羧酸对草酸钙结晶的影响

羧酸是泌尿系结石形成的抑制剂。本文采用双扩散法考察凝胶体系中一元羧酸HAc、二元羧酸酒石酸、三元羧酸柠檬酸和四元羧酸EDTA对草酸钙(CaOx)结晶的影响。HAc没有抑制作用。酒石酸和柠檬酸能够改变一水草酸钙(COM)晶体的形貌，并抑制草酸钙晶体二维生长，这种抑制作用随时间的增加而增强。EDTA使COM晶体在长度方向生长更快，而在宽度和厚度上生长更慢。随着结晶温度的降低，形成草酸钙晶体的时间增加，且二水草酸钙(COD)的比例增加。在5℃的低温条件下，添加有二元、三元和四元羧酸的CaOx结晶中，COD成为主要的物相。     

凝胶体系中不同结构羧酸盐对草酸钙生物矿化的影响

采用双扩散法研究了凝胶体系中四元羧酸盐(Na2EDTA)、三元羧酸盐柠檬酸钠（Na3cit）、二元羧酸盐酒石酸钠（Na2tart）和一元羧酸盐醋酸钠（NaAc）对草酸钙（CaOx）结晶的影响.抑制一水草酸钙（COM）聚集的能力为:Na2EDTA >Na3cit >Na2tart >NaAc；诱导二水草酸钙（COD）的能力为：Na3cit >Na2tart >Na2EDTA >NaAc.羧酸的抗衡阳离子影响CaOx的结晶. H3cit、Na3cit和K3cit抑制COM聚集和诱导COD形成的能力均为:K3cit-Na3cit >H3cit.无论是诱导COD生成，还是抑制COM聚集，均可以减小结石形成的几率，对临床上防治结石具有积极的意义.     

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.     

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.     

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.     

Simulation of calcium oxalate stone <Emphasis Type="Italic">in vitro</Emphasis>

Crystallization of calcium oxalate is studied mainly in the diluted healthy urine using scanning electron microscopy (SEM), and is compared with the crystallization in the diluted pathological urine. It suggests that the average sizes of calcium oxalate crystals are not in direct proportion to the concentrations of Ca²⁺ and Ox^2- ions. Only in the concentration range of 0.60-0.90 mmol/L can larger size of CaOx crystals appear. When the concentrations of Ca²⁺ and Ox^2- ions are 1.20, 0.80, 0.60, 0.30 and 0.15 mmol/L in the healthy urine, the average sizes of calcium oxalate crystallites are 9.5 X 6.5, 20.0 X 13.5 and 15.0 jj,m X 10.0 jj,m, respectively, for the former three samples after 6 d crystallization. No crystal appears even after 30 d crystallization for the samples of concentrations of 0.30 and 0.15 mmol/L due to their low supersaturations. The results theoretically explain why the probability of stone forming is clinically not in direct proportion to the concentrations of Ca²⁺ and Ox^2- ions. Laser scattering technology also confirms this point. The reason why healthy human has no risk of urinary stone but stone-formers have is that there are more urinary macromolecules in healthy human urines than that in stone-forming urines. These macromolecules may control the transformation in CaOx crystal structure from monohydrate cal-cium oxalate (COM) to dihydrate calcium oxalate (COD). COD has a weaker affinity for renal tubule cell membranes than COM. No remarkable effect of the crystallization time is observed on the crystal morphology of CaOx. All the crystals are obtuse hexagon. However, the sizes and the number of CaOx crystals can be affected by the crystallization time. In the early stage of crystalli-zation (1-6 d), the sizes of CaOx crystals increase and the number of crystal particles changes little as increasing the crystallization time due to growth control. In the middle and late stages (6-30 d), the number of crystals increases markedly while the growth rate changes little due to the nucleation control.     

单分子膜诱导下尿大分子对草酸钙晶体物相和晶面的调控作用

采用SEM,XRD和FTIR手段比较研究了DPPC单分子膜诱导下尿大分子硫酸软骨素A(C₄S)、硫酸软骨素C(C₆S)和血清蛋白(SA)对尿石盐草酸钙晶体生长的影响.DPPC单分子膜不但优先选择一水草酸钙(COM)物相成核生长,而且优先选择COM的(101)晶面.没有添加剂时,得到的COM为三维的六棱柱和三维的菱形晶体;加入尿大分子抑制剂后,COM的(101)晶面进一步加强,其它晶面减弱,导致二维晶体的形成.COM的(101)晶面为富钙离子晶面,带有过剩的正电荷,而DPPC单分子膜头基带有负电荷,几种尿大分子在实验条件下亦带有负电荷,带负电荷的单分子膜及带负电荷的大分子共同作用于富钙离子的(101)晶面,使得COM的(101)晶面择优生长.C₄S,C₆S和SA的存在均能有效地抑制COM生长.     

Simulation of calcium oxalate stone in vitro

Urolithiasis constitutes a serious health problem that affects a significant section of mankind. Between 3% and 14% of the population, depending on the geographical region, suffer from this illness[1]. For example, the incidence of urolithiasis in Florida in the United States of America was 15.7 in 100000 people and increased to 20.8 in 1996. Urolithiasis remains a major medical prob-lem in China, especially in Guangdong Province. A survey in 1997 in Shenzhen City, the most southern city i…     

乌梅提取液对草酸钙晶体生长的抑制作用研究

本文研究了水体系中加入乌梅提取液对草酸钙晶体生长的抑制作用,通过FTIR、SEM及XRD等测试方法对所得晶体进行表征。结果表明,不加乌梅提取液的体系中形成的晶体为一水合草酸钙(COM)晶体,加入乌梅提取液后,形成的是二水合草酸钙(COD)晶体,而且COD晶体的尺寸随着乌梅提取液浓度的增大而减小,直至消失,这说明乌梅提取液具有抑制草酸钙晶体生长的作用,且这种抑制作用随乌梅浓度的增大而增大。本文还通过电导率法研究了草酸钙晶体生长的动力学过程,发现乌梅提取液主要能抑制草酸钙晶体的成核过程。     

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…