尿酸结石患者尿液中的微晶组分及其与结石形成的关系

Components of Urinary Crystallites in Urine of Uric Acid Stone Formers and Its Relationship with Formation of Stones

采用X射线衍射（XRD）、傅里叶变换红外（FTIR）光谱、纳米粒度仪、扫描电子显微镜（SEM）和透射电子显微镜（TEM）研究了10例尿酸结石患者尿微晶的组分、Zeta电位、形貌及其与尿酸结石形成的关系。结果表明,尿酸结石患者的尿pH值较低,大都在4.8~5.7之间;尿微晶的主要成分为尿酸,其粒度分布很不均匀,从几纳米到几十微米不等,并有聚集现象。相比健康对照者尿纳米微晶的Zeta电位（-10.1mV）,尿酸结石患者的Zeta电位负值更小（-6.02 mV）。对这些患者进行药物治疗（服用柠檬酸钾）后,尿pH可上升到6.5左右,此时尿液中的大部分尿酸转变为溶解度显著增加的尿酸盐,因此,尿酸结石形成的危险性显著降低。本文结果表明,尿石组分、尿微晶组分及尿pH三者之间存在密切的联系。

The components,zeta potential,morphology of nanocrystallites in urines of 10 uric acid stone formers as well as their relationship with the formation of uric acid stones were comparatively studied using X-ray diffraction（XRD）,Fourier transform infrared（FT-IR） spectroscopy,nanoparticle size analyzer,scanning electron microscopy（SEM） and transmission electron microscopy（TEM）.The urine pH of uric acid stone formers was relatively low within the range of 4.8 to 5.7.The main constituent of urinary crystallites was uric acid.Their particle size distribution was highly uneven,ranging from several nanometers to several tens of micrometers,and obvious aggregation was observed.The zeta potential of urinary crystallites in ten lithogenic patients was-6.02 mV,which was higher than that in ten normal subjects（-10.1 mV）.After drug therapies （potassium citrate was taken）,the urine pH value of the uric acid stone formers increased to 6.5 or so,and at this pH value most of the uric acid had changed to urate.Since the solubility of urate increased greatly than uric acid,the risk of the formation of uric acid stone reduced.The results in this paper showed that there was a close relationship among stone components,urinary crystallites composition and urine pH.