【作者】 陶芝伟；

【导师】 邓耀良；

【作者基本信息】 广西医科大学 ， 泌尿外科， 2010， 硕士

【摘要】 目的通过对草酸钙肾结石患者肾结石、肾盂尿液和肾乳头钙化斑组织标本的钙化性纳米微粒检测,探讨钙化性纳米微粒与草酸钙肾结石形成的关系；通过肾乳头钙化组织的超微结构观察,阐述钙化性纳米微粒致草酸钙肾结石形成的可能机制。方法1、收集20例草酸钙肾结石患者的肾结石、肾盂尿液和肾乳头钙化组织标本,分离和培养钙化性纳米微粒,并应用Von kossa染色、电镜、X线能谱、傅里叶变换红外光谱等技术检测钙化性纳米微粒的存在,取6例肾脏肿瘤患者的肾盂尿液、肾乳头组织标本作为对照,RPMI 1640培养液作为空白对照。2、在光镜下观察钙化性纳米微粒检测阳性的草酸钙肾结石患者的肾乳头钙化组织中钙盐沉积的部位,并利用电镜对该组织的超微结构进行观察。3、在不同的时间段,利用扫描电镜对肾结石、肾盂尿液和肾乳头钙化组织标本来源的钙化性纳米微粒的形态变化进行观察。结果草酸钙肾结石患者的肾结石核心、表面、肾盂尿液和肾乳头钙化组织标本中均检测到钙化性纳米微粒的存在,阳性率分别为75%、60%、55%、65%。扫描电镜观察发现肾乳头钙化组织内存在大量钙化性纳米微粒,这些微粒聚集成团,粘附于小管上皮,并被内吞。透射电镜下,在肾乳头钙化组织间质中也发现了类似钙化性纳米微粒的颗粒,髓攀间质中的钙化斑结构与钙化性纳米微粒在体外培养了40周的形态极为相似。结论钙化性纳米微粒与草酸钙肾结石的形成存在密切联系：钙化性纳米微粒可能参与肾乳头钙化-草酸钙肾结石的形成过程。肾结石、肾盂尿液和肾乳头钙化组织标本来源的钙化性纳米微粒的形态在无血清的培养环境中具有多形性。更多还原

【Abstract】 Objective To investigate the relationship between calcifying nanoparticles and calcium oxalate kidney stone formation.Method Kidney stones, renal pelvis urine and renal papilla calcified tissue spices were collected from 20 patients who were suffered from calcium oxalate kidney stones. Electron microscopy, Von kossa staining, X ray spectroscopy, Fourier transform infrared spectroscopy technologies were applied for identifying these calcifying nanoparticles. RPMI 1640 medium was as blank control.6 cases of patients with kidney tumor were in control group.2 The renal papilla calcified tissue in which the detection of calcifying nanoparticles were positive were searched for calcium salts site by light microscope.The ultrastructure of renal papilla calcified tissue were observed by electron microscopy.3 The morphology of calcifying nanoparticles which were cultured under free-serum was observed by electron microscopy in different periods.Results The calcifying nanoparticles positive rate in the spices of patients with calcium oxalate kidney stones was as follows:the core of kidney stone was 75%, surface was 60%, renal pelvis urine was 55%, and renal papillary calcifying tissue was 65%. A large number of calcifying nanoparticles were observed in renal papilla calcified tissue by scanning electron microscope, these particles adhered to the tubular epithelial cells. The particles which were similar to calcifying nanoparticles were also found in this tissue by transmission electron microscopy. The structure of calcifying nanoparticles under 40 weeks culture was similar to the Randall’s plaque.Conclusion Calcifying nanoparticles are in close contact with the formation of calcium oxalate kidney stones:The appearance of these particles in calcified renal papillary tissue suggests that calcifying nanoparticles may play an important role in formation of calcified renal papilla-calcium oxalate kidney stones.The morphology of calcifying nanoparticles under free-serum culture is pleomorphic.更多还原