肾结石患者尿沉渣中骨桥蛋白检测的意义

Detection of osteopontin in urine from patients with kidney stones

目的:检测肾结石患者尿沉渣中骨桥蛋白(OPN)的水平,探讨OPN在泌尿系结石发病中的作用。方法:33例肾结石患者纳入研究,并以同期健康体检者30例作为对照,采用RT-PCR检测尿沉渣中OPNmRNA的表达水平,同时测定尿晶体成分,计算尿中的离子活度积。结果:肾结石患者和健康体检者尿沉渣脱落细胞中均见有OPNmRNA的表达,但结石组患者OPNmRNA表达的强度明显低于健康体检者(t=5.599,P=0.000)。尿晶体成分测定显示肾结石患者的尿钙(t=1.147,P=0.256)和草酸浓度(t=1.121,P=0.367)与健康体检者水平相当,但尿镁(t=7.417,P=0.000)和柠檬酸(t=7.601,P=0.000)浓度明显低于健康体检者,尿磷(t=4.313,P=0.000)和尿酸(t=6.003,P=0.000)高于健康体检者,而AP[CaOx]指数(t=5.599,P=0.000)和AP[CaP]指数(t=5.599,P=0.000)结石组明显高于健康体检组。并且AP[CaOx]指数及AP[CaP]指数和OPNmRNA表达水平均呈负相关,其相关系数分别为rAP[CaOx]=-0.746(t=5.147,P=0.003);rAP[CaP]=-0.711(t=0.489,P=0.016)。结论:骨桥蛋白的表达下调可能与肾结石的发生有一定的关系。

Objective： To detect the osteopontin （OPN） expression in the urinary sediment from patients with kidney stones, found the effects in the pathogenesis of urinary calculi role. Methods： 33 patients with kidney stones, and 30 healthy volunteers as controls enrolled in this study. RT-PCR were used for detection of OPN mRNA expression. The au thor also detected the urine crystal components, and calculation of ion activity product in urine. Results： The OPN mRNA were expressed both in the kidney stone patients and healthy controls, but kidney stone patients had a significantly lower expression of OPN mRNA than that of healthy controls （t=5.599, P=0.000）. Determination of crystal components in urine showed urine calcium （t=1.147, P=0.256） and oxalic acid concentration （t=1.121, P=0.367） had the same expression in two group. But urinary magnesium （t=7.417, P=0.000） and citric （t=7.601, P=0.000） in kidney stone patients was significantly lower than that of healthy controls. Urinary phosphorus （t=4.313, P=0.000） and uric acid levels （t=6.003, P=0.000） was higher than that of healthy controls. While AP[CaOx] index （t=5.599, P=0.000） and AP[CaP] index （t=5.599, P=0.000） were significantly higher than that of healthy stone group. Further more, AP[CaOx] index and the AP[CaP] index was negatively correlated with the expression of OPN mRNA level, the correlation coefficients were rAP [CaOx]=-0.746 （t=5.147, P=0.003）; rAP[CaP]=-0.711 （t=0.489, P=0.016）. Conclusion： The reduced expression of OPN may play a important role in the incidence of kidney stones.