尿液中的纳米晶体组分及其对草酸钙结石形成的影响

采用高分辨率透射电子显微镜、选区电子衍射、能谱分析和X射线衍射对草酸钙(CaOx)结石患者尿液中纳米晶体的组分进行了准确分析。这些技术检测到一水草酸钙(COM)、尿酸(UA)和磷酸钙(CaP)的存在，能谱分析检测到大量C，O，Ca和少量N和P等元素，表明尿纳米晶体的主要组分是COM，并含有少量的尿酸和磷酸盐。电子显微镜观察到CaOx结石患者尿纳米晶体的粒径主要分布在几十纳米，其结果与Scherer公式计算相符。采用不同孔径的微孔滤膜(0.45，1.2和3 μm)将尿液过滤后，得到的尿微晶衍射峰的数量随着滤膜孔径的增加而增加，表明尿微晶的种类增加。CaOx尿石的形成过程涉及尿液晶体的成核、生长、团聚和与细胞的粘附等过程。尿液中大量纳米COM晶体的存在是草酸钙结石形成的重要原因。纳米UA，CaP晶体能够作为晶巢促进草酸钙结石的形成。

Components of Urinary Nanocrystals and Their Influence on Formation of Calcium Oxalate Stones

High-resolution transmission electron microscopy, X-ray diffraction, selected area electron diffraction (SAED), and energy dispersive spectroscopy (EDS) were accurately performed to analyze the components of nanocrystals in the urine of patients with calcium oxalate (CaOx) stones. XRD, SAED and FFT detected the presence of calcium oxalate monohydrate (COM), uric acid (UA), and calcium phosphate (CaP). EDS detected the elements of C, O, Ca, with a small amount of N and P. These results showed that the main components of urinary nanocrystals were COM, with a small amount UA and phosphate. HRTEM observation showed that the particle size of urinary nanocrystals was dozens of nanometers. The result was consistent with the calculation by Debye-Scherrer equation. When the urine was filtered through a microporous membrane of 0.45, 1.2, and 3 μm, respectively, the number of diffraction peaks of the obtained urine crystallites increased with the increased pore size, indicating the increase of urinary crystallite species. Crystal nucleation, growth, aggregation, and adhesion of crystals to the renal epithelial cells are important processes for CaOx stone formation. The presence of a large amount of COM crystals in patients’ urine is a critical factor for CaOx stones formation. Nano UA and CaP crystallite can induce the CaOx stone formation as central nidus.