尿钙水平对草酸钙结石患者尿液MCP-1和MDA生成的影响  

Influence of urinary calcium on the production of urinary MCP-1 and MDA in patients with calcium oxalate calculus

作　　者：熊燕祥[1] 黎承杨[1] 邓耀良[1] 曾国华[2] 

机构地区：[1]广西医科大学第一附属医院泌尿外科,南宁530021 [2]广州医学院第一附属医院泌尿外科

出　　处：《临床泌尿外科杂志》2013年第9期685-689,共5页Journal of Clinical Urology

基　　金：广西自然科学基金资助项目(编号2011GXNSFA018177);广东省泌尿外科重点实验室项目(编号2010A060801016)

摘　　要：目的:探讨尿钙水平在结石形成过程中的作用。方法:选择草酸钙结石住院患者110例,按尿钙水平分为两组,24小时尿钙≥240mg/d的35例纳入高尿钙结石组,24小时尿钙<240mg/d的75例纳入低尿钙结石组;同时随机挑选30例无泌尿系结石的健康者作对照组。收集三组尿液,分别运用ELLISA和TBA法检测尿液中细胞因子MCP-1、TGF-β和脂质过氧化产物丙二醛(MDA)的含量。结果:MCP-1在高尿钙组、低钙尿组和健康对照组间的含量分别为36.7(23.71,50.22)pg/ml、29.22(20.40,40.29)pg/ml、26.98(13.59,38.60)pg/ml;与其他两组比较,高尿钙组尿液中MCP-1生成增多(P<0.05)。TGF-β在三组间含量无差别(P>0.05)。MDA在高尿钙组、低钙尿组和健康对照组间的含量分别为2.02(1.05,2.95)nmol/ml、1.70(1.00,2.18)nmol/ml、1.19(0.73,1.41)nmol/ml;与健康对照组比较,高尿钙结石组和低尿钙结石组尿中MDA生成增加(P<0.05);高尿钙结石组和低尿钙结石组尿中MDA则无明显差异(P>0.05)。相关性分析,尿钙水平与尿MCP-1水平存在正相关关系,r=0.226,P<0.05;尿钙水平与MDA水平无明显相关关系(P>0.05)。结论:高尿钙可促进草酸钙结石患者尿液MCP-1生成增多,TGF-β的生成无明显变化。草酸钙结石患者尿液MDA水平升高,提示肾脏氧化应激水平增加,但高尿钙并未影响患者尿MDA的生成水平,提示高尿钙在草酸钙结石患者肾脏氧化应激损伤中不起主要的作用。Objective：To investigate the role of urinary calcium in the formation of kidney stone. Method：One hundred and ten hospitalized patients with calcium oxalate stones were investigated. According to the urinary calcium levels, the patients were divided into two groups, group H： the urine calcium ≥240 mg/24 h , a total of 35 cases; group L： the urine calcium 〈240 mg/ 24 h, a total 75 cases. Thirly healthy people without urinary disease were randomly selected as control group, marked as group C. Cytokines MCP-1, TGF-β and MDA in urine were measured by the methods ELISA and TBA respectively. Result：The urinary MCP -1 levels in three groups were 36. 7 （23.71, 50.22） pg/ml, 29.22 （20.40, 40.29） pg/ml, 26.98 （13.59, 38.60） pg/ml, respectively. Compared with the other two groups, MCP-1 in the high urinary calcium stone group increased （P〈0. 05）. Statistics showed that there were no significant differences between the three groups in urinary TGF-β level （P〉0.05） . Compared with the group C, urinary MDA level increased in the groups H and L （P〈0.05） , but there was no statistical differences between groups H and L. Correlation analysis showed that there was a positive correlation between urinary calcium level and urinary MCP-1 level. However, there was not a correlation between urinary calcium level and urinary MDA level. Conclusion：Results suggest that hypercalciuria promoted the expression of urinary MCP-1 in calcium oxalate stones patients, but it has no obvious effect on the urinary TGF-13. Increased level of urinary MDA in calcium oxalate kidney stone patients indicated the existence of renal oxidative stress. But high urinary calcium levels do not increase the level of urinary MDA, which indicates that renal oxidative stress damage may not primarily induced by hypercalciuria.

关 键 词：高钙尿症 草酸钙结石 单核细胞趋化蛋白-1 丙二醛 

分 类 号：R696[医药卫生—泌尿科学] R691.4[医药卫生—外科学]