泌尿系统结石成分谱及与血清TG、TC及PGE2水平的相关性

目的分析泌尿系统结石成分谱及与血清三酰甘油(TG)、总胆固醇(TC)及前列腺素E2(PGE2)水平的相关性。方法选取2015年5月至2018年12月于该院就诊的肾结石患者1875例为患者组,选取同期于该院体检合格的健康者83例为对照组。在征得受试者同意的前提下,分别于进入研究队列时刻(T0)及治疗后即入选后第90天(T1)对受试者进行血液标本采集(对照组仅采集T0时的血液标本),采用酶联免疫吸附测定(ELISA)检测血清TG、TC及PGE2水平。结果1875例患者中1677例患者的主要结石成分为草酸钙;主要结石成分为磷酸磷灰石的患者为117例;主要结石成分为尿酸的患者55例;主要结石成分为磷酸镁铵的患者23例;主要结石成分为胱氨酸的患者3例。不同结石成分患者24h尿量及尿pH值比较,差异均无统计学意义(P>0.05)。患者组和健康组血清TG、TC及PGE2水平比较,差异均有统计学意义(P<0.05)。患者组T0和T1的血清TG、TC及PGE2水平比较,差异均有统计学意义(P<0.05)。以治疗后水平为基线,血清TG、TC及PGE2水平均存在两两间的正相关(P<0.05)。草酸钙结石患者肾组织标本切片的HE染色显示,肾小管有扩张表现,且多数肾小管中存在草酸钙结晶或结晶团块。结论荆门地区泌尿系统结石成分以草酸钙为主,血清TG、TC及PGE2水平有助于泌尿系统结石的诊断;相比于其他结石成分,草酸钙结石对肾组织损伤更为明显。

The correlation between urinary calculus composition and serum total cholesterol,triglyceride and estradiol levels

Objective To analyze the component spectrum of urinary calculi and its correlation with serum cholesterol(TG),triglyceride(TC)and prostaglandin E2(PGE2)levels.Methods From May 2015 to December 2018,1875 patients with renal calculi were enrolled in the study.With the consent of the patients,biological samples were taken at the time of enrollment(T0)and the 90 th day after enrollment when treatment was finished(T1).The patients were fed a low protein diet 12 hbefore sampling,and 10 mL blood samples were taken.Serum TG,TC and PGE2 levels were analyzed by ELISA.Results Among 1875 cases,1677 cases were mainly composed of calcium oxalate,117 cases of apatite phosphate,55 cases of uric acid,23 cases of magnesium ammonium phosphate and 3 cases of cystine.There was no significant difference in 24-hour urine volume and pH value among the patients with different stone components(P>0.05).The serum TG,TC and PGE2 levels of the patients in the patients group and the healthy group were statistically different,and the serum TG,TC and PGE2 levels in the patients group at the time of T0 and T1 were statistically different(P<0.05).There was a positive correlation between the levels of TG,TC and PGE2(P<0.05).HE staining showed that the renal tubules were dilated,and most of the renal tubules had calcium oxalate crystals or crystal masses.Conclusion Calcium oxalate is the main component of urinary calculi in Jingmen area.Serum TG,TC and PGE2 levels are helpful for the diagnosis of urinary calculi.Compared with other calculi,calcium oxalate calculi have more obvious damage to renal tissue.