【摘要】 目的探寻影响尿结晶形成的关键因素,为预防尿石症(USD)提供理论依据。方法收集健康人1年的尿液,观察每一份尿液的清澈与浑浊情况,测定并分析尿液pH、比重和尿量等理化指标与浑浊尿液之间的相关性。对浑浊尿液析出的结晶进行显微镜观察,分析结晶析出时尿液的理化状况。取清澈尿液和浑浊尿液,用HCl和NaOH调节酸碱性,观察pH改变对尿结晶形成的影响。结果尿液中是否析出结晶与尿pH密切相关,与尿比重和尿量没有统计学意义(P>0.05)。尿液在pH5.5~6.4范围时清澈透明,在pH=6.5时开始产生结晶(概率为2.3%);当pH升至7.5时产生结晶的概率升高至89%。无论清澈还是浑浊尿液,用HCl调节pH至6.0~5.0时均变清澈透明,继续调节pH至4.0以下则有少量结晶析出;用NaOH调节pH至7.0~7.5时尿液均变浑浊、并析出大量结晶而沉淀。结论对于健康人,尿液pH改变是产生结晶的重要诱因,而结晶物出现是生成结石的前提条件;尿液pH维持在5.0~6.5是预防尿液结晶的有效范围;随尿液pH升至6.6以上,析出结晶的程度和比例呈正比升高,pH>7.0是诱发USD的高危因素。更多还原

【Abstract】 Objective To explore the key factors in the formation of urinary crystal in order to probe into the theoretical foundation in the prevention of urinary stone disease(USD).Methods Urine samples were collected from healthy people within a year to observe whether they were clear or turbid.The correlation between the physicochemical indexes and pH value,density and volume was analyzed.The crystal from turbid urine samples was observed with microscope to analyze the physicochemical environment.The pH values of both clear and turbid urine samples were adjusted using hydrochloric acid or sodium hydroxide to observe how they affected the crystallization.Results The formation of urinary crystal was closely associated with the pH value,but not with the density or volume(P>0.05).The urine was completely clear when the pH value was 5.5~6.4.The probability of crystallization was 2.3% when the pH value was 6.5;the probability reached 89% when the pH value was 7.5.Both clear and turbid urine samples could become clear when the pH value was adjusted to 6.0~5.0by adding hydrochloric acid;crystal appeared when the pH value was adjusted below 4.0.Moreover,the urine became turbid with more crystal when sodium hydroxide was added and the pH value was adjusted to 7.0~7.5.Conclusions For healthy people,change of pH value is an important incentive of urinary crystallization,which is in turn the prerequisite of urinary stone formation.The best range of pH value to prevent urinary crystal is 5.0~6.5.When the pH value is>6.6,the crystallization possibility and amount of urinary crystal will increase.A pH value>7.0is a risky inducer of USD.更多还原