草酸钙结石的体外模拟

运用扫描电子显微镜(SEM)重点研究了正常人尿液中草酸钙(CaO_x)的结晶, 并与在尿石患者尿液中的结晶进行了比较. 在正常人尿液中, CaO_x晶体的大小并不与[Ca²⁺]和[Ox^2-]的起始浓度成正比, 而是只有在0.60 ~ 0.90 mmol/L的浓度范围内, 才形成最大尺寸的CaO_x晶体. 当CaO_x浓度依次为1.20, 0.80, 0.60, 0.30和0.15 mmol/L时, 结晶6 d后前三者得到的CaO_x晶体的平均尺寸分别为9.5 μm×6.5 μm, 20.0 μm×13.5 μm和15.0 μm×10.0 μm, 后两者因相对过饱和度小, 30 d仍没有结晶出现. 这一结果从理论上支持了近年来临床上得出的结论：并不是尿中Ca²⁺离子浓度越大就越易形成结石, 这一结论同时被激光散射技术所证明. 由于正常人尿液中含有比结石患者尿液中更多的或活性更强的可与Ca²⁺配位的大分子物质, 这些大分子不但可以抑制CaO_x的成核、生长和聚集, 而且还能调控CaO_x晶体结构从一水草酸钙(COM)向与细胞亲合力较小的二水草酸钙(COD)的转化, 因而, 正常人不易形成CaO_x结石, 而患者容易形成. 结晶时间对晶体形状的影响不明显, 均得到圆角的六边形CaO_x晶体, 但影响晶体的大小和密度. 在结晶初期(1 ~ 6 d内)晶体尺寸随结晶时间的延长逐渐增大, 表明此时CaO_x结晶为生长控制; 而在结晶的中后期(6 ~30 d), CaO_x晶体的密度明显增加, 生长速率减慢, 表明此时CaO_x结晶为成核控制.     

改变枸橼酸和EDTA抗衡阳离子对草酸钙结石抑制作用的体外模拟

The effects of counterions of citric acid and EDTA on the crystallization of calcium oxalate (CaO_x) were in-vestigated in silica gel with a double diffusion technique. The ability of inhibiting the growth and aggregation of CaO_x crystal and the ability of inducing formation of COD follows： potassium citrate 》 sodium citrate >citric acid. Na₂EDTA had a stronger ability to inhibit the aggregation of CaO_x crystals than that of EDTA， but a weaker ability to inhibit nucleation and growth of CaO_x crystals. Since COM exhibits a greater degree of attachment to renal tubule cells in culture compared with COD， that is， COD is easy to be expelled from the body along with the urine. So both inducing formation of COD and inhibiting growth and aggregation of CaO_x crystal can decrease the probability of urinary stones. These results have positive significance in the prevention and cure of urinary stones clinically.     

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…