偏光显微镜诊断早期尿石病

目的：尿石发生早期难以确诊,本研究对有临床症状但影像学阴性的肾内微结石探索早期的诊断方法。方法：用乙二醇制作大白鼠草酸钙尿石动物模型,用偏光显微镜对模型动物的尿沉渣和对30例已确诊尿石患者的尿沉渣进行比较,观察尿沉渣中的红细胞、管型和晶体类型,找出其中相同的组分作为诊断指标;尿石患者用叶金胶囊治疗。结果：模型动物及尿石患者的尿沉渣中多数有晶化红细胞、少数有晶体管型,并伴有大量晶体。动物模型晶体可见一水、二水草酸钙晶,十字型晶或无定型尿酸晶。尿石患者晶体特点同时有微晶、亦可见晶体铸型。30例尿石患者口服叶金胶囊,其中有8例排出小结石或镜下结石。结论：用偏光显微镜诊断早期尿石病,方法简单可靠,具有可行性。

Diagnostic Method for Early Urolithiasis with Polarizing Microscopy

Objective It is difficult to diagnose the early stage of urolithiasis. The aim of this study is to search the diagnostic method of intrarenal microstones for patients with clinical manifestations but negative imag- ing. Methods The calcium oxalate rat model is made by glycol,Urine sediments such as red blood cell,uri- nary cylinder, crystal type were observed by polarizing microscopy between rat model and 30 patients diagnosed with urinary stone. Same components were used for diagnostic index, the patients are treated by yejing capsule. Results Urine sediments in rat model and patients both have crystallization of red blood cells mostly, crystal type and urinary cylinder in small numbers accompanied lots of crystals.The rat model have calcium oxalate monohydrate and crystal calcium oxalate crystal,cross crystal or the amorphous uric acid crystals.the character of crystal in patient is both have mierocrystal crystal mold,8 eases in 30 are discharge small stone or the microscop- ic calculi.Conclusion It is easy and feasible to use polarizing microscopy to diagnose early urolithiasis.