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目的:探讨尿钙水平在结石形成过程中的作用。方法:选择草酸钙结石住院患者110例,按尿钙水平分为两组,24小时尿钙≥240mg/d的35例纳入高尿钙结石组,24小时尿钙<240mg/d的75例纳入低尿钙结石组;同时随机挑选30例无泌尿系结石的健康者作对照组。收集三组尿液,分别运用ELLISA和TBA法检测尿液中细胞因子MCP-1、TGF-β和脂质过氧化产物丙二醛(MDA)的含量。结果:MCP-1在高尿钙组、低钙尿组和健康对照组间的含量分别为36.7(23.71,50.22)pg/ml、29.22(20.40,40.29)pg/ml、26.98(13.59,38.60)pg/ml;与其他两组比较,高尿钙组尿液中MCP-1生成增多(P<0.05)。TGF-β在三组间含量无差别(P>0.05)。MDA在高尿钙组、低钙尿组和健康对照组间的含量分别为2.02(1.05,2.95)nmol/ml、1.70(1.00,2.18)nmol/ml、1.19(0.73,1.41)nmol/ml;与健康对照组比较,高尿钙结石组和低尿钙结石组尿中MDA生成增加(P<0.05);高尿钙结石组和低尿钙结石组尿中MDA则无明显差异(P>0.05)。相关性分析,尿钙水平与尿MCP-1水平存在正相关关系,r=0.226,P<0.05;尿钙水平与MDA水平无明显相关关系(P>0.05)。结论:高尿钙可促进草酸钙结石患者尿液MCP-1生成增多,TGF-β的生成无明显变化。草酸钙结石患者尿液MDA水平升高,提示肾脏氧化应激水平增加,但高尿钙并未影响患者尿MDA的生成水平,提示高尿钙在草酸钙结石患者肾脏氧化应激损伤中不起主要的作用。
Objective: To investigate the role of urinary calcium in stone formation. Methods: A total of 110 hospitalized patients with calcium oxalate stones were divided into two groups according to the level of urinary calcium. Thirty-five patients with 24-hour urinary calcium ≥ 240 mg / d were enrolled in the group of hyperuricemia and 24-hour urinary calcium was less than 240 mg / d Low urinary calculus group; at the same time randomly selected 30 cases without urinary calculi in healthy control group. Three groups of urine samples were collected for detection of cytokines MCP-1, TGF-β and malondialdehyde (MDA) in urine by ELLISA and TBA respectively. Results: The contents of MCP-1 in high-calcium group, low-calcium urine group and healthy control group were 36.7 (23.71,50.22) pg / ml, 29.22 (20.40,40.29) pg / ml and 26.98 (13.59,38.60) pg / ml. Compared with the other two groups, the production of MCP-1 in the urine of high-calcium group increased (P <0.05). TGF-β content in the three groups no difference (P> 0.05). The contents of MDA in hyperuricemia group, low calcium group and healthy control group were 2.02 (1.05, 2.95) nmol / ml, 1.70 (1.00, 2.18) nmol / ml and 1.19 Compared with the healthy control group, the urinary MDA levels increased in the group of high urinary calcium and low urinary calculus (P <0.05), but there was no significant difference in the level of MDA in the group of high urinary calcium and low urinary calcium (P> 0.05 ). Correlation analysis showed that there was a positive correlation between urinary calcium level and urinary MCP-1 level (r = 0.226, P <0.05). There was no significant correlation between urinary calcium level and MDA level (P> 0.05). Conclusion: High urinary calcium can promote the formation of urinary MCP-1 in patients with oxalic acid stones, and there is no obvious change in TGF-β production. Oxalic acid levels in patients with calcium oxalate stones, suggesting that the level of oxidative stress in the kidneys increased, but high urinary calcium did not affect the level of urinary MDA in patients with urinary calcium, suggesting that high urinary calcium in oxalic acid stones in patients with renal oxidative stress injury can not afford The main role.