肾乳头钙斑病变的研究进展

The progress of renal papillary calcium plaque lesions

肾结石的发病机制复杂,目前普遍认可的是异常的尿液状况或肾小管上皮细胞损伤等因素导致肾乳头上皮下钙斑(Randall斑块)或者阻塞肾小管的结石晶体(Randall钙栓)的形成,然后过饱和的晶体聚集在Randall斑块或钙栓上进而形成结石。然而,肾乳头钙斑病变的病理生理变化及表现形式还包括肾乳头锚定结石、肾乳头隐窝内结石、肾乳头尖端糜烂、外生型肾乳头等肾乳头病变。本文着重介绍Randall斑块学说的发展进程,和Randall斑块的形成和转变机制,以及上述不同类型肾乳头钙斑病变的表现和临床处理方式,对Randall斑块、伴随结石的肾乳头病变、与结石相关的肾乳头病变3个方面进行了综述。

The formation mechanism of kidney stones is complex.It is generally recognized that abnormal urine conditions or renal tubular epithelial cell damage,together with other factors cause the formation of renal papillary subepithelial calcium plaques(Randall’s plaques)or stone crystals that block the renal tubules(Randall’s plugs),and then oversaturated crystals gathering on Randall's plaque or plug and forming stones.However,there are many pathophysiological changes and manifestations,such as renal papillary anchoring stones,renal papillary crypts,renal papillary tip erosion,and exogenous renal papilla Renal papillary lesions,which may be an early manifestations before the formation of kidney stones.The study of renal papillary calcium plaque is very important for the pathogenesis of kidney stones,as well as the prevention and treatment of patients with stones.By focusing on the development process of Randall plaque theory,the formation and transformation mechanism of Randall plaque,as well as the manifestations and clinical treatment of the above mentioned different types of renal papillary calcium plaque lesions,this article reviewed three aspects of stone formation,including Randall’s plaque,renal papillary lesions with stones,and renal papillary lesions related to stone.