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目的观察尿钙水平对含钙肾结石患者尿液炎症细胞因子生成的影响,探讨尿钙和炎症细胞因子在结石形成过程中的作用。方法选取含钙肾结石患者81例,分为两组:24 h尿钙≥4 mg/(kg·d)纳入高钙尿结石组(H组,32例),24 h尿钙<4 mg/(kg·d)纳入低钙尿结石组(L组,49例),随机选取30例无泌尿系结石的健康者作为对照组(C组)。检测3组晨尿中单核细胞趋化蛋白-1(MCP-1)、三叶因子1(TFF1)、高迁移率族蛋白1(HMGB1)的水平,比较尿钙水平与各细胞因子之间以及各细胞因子之间的相关性。结果 MCP-1在H组、L组、C组分别为196.2(35.22,502.89)、217.60(66.62,766.87)和72.45(18.87,196.79)pg/mg;组间比较,H组和L组均高于C组(P<0.05),但H组与L组比较差异无统计学意义(P>0.05)。TFF1在H组、L组、C组分别为15.24(9.68,29.88),30.04(12.12,43.39)和22.45(15.31,42.09)ng/mg;与其他两组对比,H组TFF1生成减少(P<0.05);TFF1在L组和C组间差异无统计学意义(P>0.05)。HMGB1在H组、L组、C组分别为(单位pg/mg):2 896.24(1 592.80,7 057.64),3 052.76(1 194.95,6 838.55)和1 717.32(733.69,2854.56);组间比较,H组和L组HMGB1均高于C组(P<0.05),但H组与L组比较差异无统计学意义(P>0.05)。相关性分析:H组尿钙水平与尿液TFF1呈负相关(r=-0.384,P<0.05);与MCP-1水平呈正相关(r=0.353,P<0.05)。在总体111个样本中,尿液MCP-1与尿液TFF1呈负相关(r=-0.21,P<0.05)。结论含钙肾结石患者尿液MCP-1、HMGB1水平有明显升高。高钙尿可以促使含钙肾结石患者尿液TFF1下降,但尿钙水平对MCP-1、HMGB1无明显影响,结石患者尿液MCP-1和HMGB1升高可能是多种损伤因素共同作用的结果。炎症细胞因子之间存在相关关系。
Objective To investigate the effect of urinary calcium on urine cytokine production in patients with calcium-containing nephrolithiasis and the role of urinary calcium and inflammatory cytokines in the formation of calculi. Methods Eighty-one patients with calcium-containing nephrolithiasis were enrolled and divided into two groups: 24 hours urinary calcium ≥4 mg / (kg · d) into hypercalciuria group (H group, 32 cases), 24 h urinary calcium <4 mg / (kg · d) were included in the group of low calculus calculi (group L, 49 cases), and 30 healthy people without urinary calculi were randomly selected as the control group (group C). The levels of monocyte chemoattractant protein-1 (MCP-1), trefoil factor 1 (TFF1), and high mobility group box 1 (HMGB1) in the morning urine of three groups were measured and the urinary calcium levels were compared with those of cytokines As well as the correlation between the various cytokines. Results The levels of MCP-1 in group H, group L and group C were 196.2 (35.22,502.89), 217.60 (66.62,766.87) and 72.45 (18.87, 196.79) pg / mg, respectively In group C (P <0.05), but there was no significant difference between group H and group L (P> 0.05). TFF1 in H group, L group and C group were 15.24 (9.68,29.88), 30.04 (12.12,43.39) and 22.45 (15.31, 42.09) ng / mg, respectively. Compared with the other two groups, 0.05). There was no significant difference in TFF1 between L group and C group (P> 0.05). HMGB1 in group H, group L and group C were respectively (pg / mg) 2,896.24 (1 592.80,7 057.64), 3 052.76 (1 194.95,6 838.55) and 1 717.32 (733.69,2854.56) (P <0.05). There was no significant difference between H group and L group (P> 0.05). Correlation analysis: Urinary calcium level in group H was negatively correlated with urine TFF1 (r = -0.384, P <0.05), but positively correlated with MCP-1 level (r = 0.353, P <0.05). In a total of 111 samples, urine MCP-1 was negatively correlated with urine TFF1 (r = -0.21, P <0.05). Conclusion Urinary MCP-1 and HMGB1 in patients with calcium-containing nephrolithiasis were significantly increased. Hypercalciuria can promote urinary TFF1 in patients with calcium-containing nephrolithiasis decreased, but urinary calcium levels had no significant effect on MCP-1 and HMGB1. Increased urinary MCP-1 and HMGB1 in patients with stone may be the result of a combination of various injury factors . There is a correlation between inflammatory cytokines.