【摘要】 目的:探讨一种三聚氰胺尿路结石的发生机制模型。方法:收集三聚氰胺尿路结石24枚(试验组),随机选择19枚成人尿路结石作为对照组,测定试验组患儿肾功能和血尿酸、肌酸水平。使用高效液相色谱法测定结石样本肌酐、肌酸和尿酸含量,使用高分辨透射电镜研究上述结石提取物、人工制备的三聚氰胺-三聚氰酸聚合物、色谱级尿酸、肌酸和肌酐标准品结构。结果:试验组患儿血生化指标均正常,且无个体间显著差异。试验组结石肌酸(6.17±8.09μg/g vs 0.19±0.16μg/g,P=0.000)和肌酐(20.49±21.91μg/g vs 2.09±1.06μg/g,P=0.008)含量较对照组显著增高。但患儿血生化指标与上述结石指标之间无明显相关(P>0.05)。电镜研究显示:试验组结石核心区域提取物中发现的网状结构与人工制备的三聚氰胺-三聚氰酸聚合物结构极其相似,而且肌酸、肌酐和尿酸分子均小于上述网状结构网格尺寸。结论:本研究首次证实三聚氰胺结石中存在独特的类三聚氰胺-三聚氰酸聚合物的网状结构,其可能参与结石发生中的成核作用。更多还原

【Abstract】 Objective:To investigate a plausible mechanism model for melamine urinary stone formation.Meth- od:A total of 24melamine urinary stones(served as experimental group)and 19adult urinary stones(served as controlled group)were included.Renal function,blood creatine and uric acid levels before treatment were meas- ured in experimental children.Uric acid,creatinine and creatine levels were measured quantitatively in all samples using high-performance liquid chromatography.Transmission electron microscope was used to investigate the structure of extractions from experimental and controlled groups,artificial prepared melamine-cyanurate complex as well as chromatographic grade uric acid,creatine and creatinine.Result:The blood biochemical indices in experi- mental children were within normal range and no individual difference was found among them.Compared with con- trolled group,urinary stones of experimental group contained more creatinine and creatine(creatine 6.17±8.09 μg/g vs 0.19±0.16μg/g,P=0.000;creatinine 20.49±21.91μg/g vs 2.09±1.06μg/g,P=0.008).Howev- er,there was no relationship between experimental children’s blood biochemical indices and the above stone indices(P>0.05).Transmission electron microscope showed that networks found in extraction from melamine urinary stones core area were very similar to those in artificial prepared melamine-cyanurate complex.Moreover,the single molecular size of creatine,creatinine and uric acid was less than the above mesh.Conclusion:It is the first study to demonstrate existence of distinct melamine-cyanurate-like assemblies networks in melamine urinary stones,which might participate in the process of nucleation.更多还原