稀土元素对江西赣南地区稀土暴露人群肾结石形成的影响初步研究
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摘要
目的:初步探讨稀土元素(rare earth,RE)与江西赣南地区稀土暴露人群泌尿系结石形成的影响。方法:随机选择180例江西赣南稀土暴露地区肾结石患者为研究组和180例非稀土暴露地区肾结石患者为对照组,剔除继发性肾结石,包括胱氨酸结石、尿酸盐结石及磷酸盐结石,研究组共173例,对照组171例。分别采用电感耦合等离子体发射光谱法和美国PE公司EAAN-5000型电感耦合等离子体质谱仪(ICP-MS)检测两组患者肾结石标本和血浆中RE的含量。结果:研究组肾结石中镝(Dy)、镱(Yb)、铥(Tm)、钆(Gd)、铒(Er)元素的含量显著高于对照组(P<0.05)。研究组血浆中Dy、Yb、Tm、镥(Lu)、镨(Pr)、钕(Nd)浓度显著高于对照组(P<0.05)。而镧(La)、铈(Ce)、钐(Sm)、铕(Eu)、铽(Tb)、钬(Ho)等元素的含量在两组间差异均无统计学意义(P>0.05)。结石成分分析中,剔除继发性结石,研究组以混合性结石成分为主,对照组中以单纯性草酸钙成分为主,差异有统计学意义(P<0.05)。结论:Dy、Yb、Tm等元素可能影响江西赣南地区稀土暴露人群尿路结石的形成。
Objective:To investigate the effect of rare earth on the formation of urolithiasis in rare earth exposure population from Jiangxi province Gannan district.Method:The rare earth exposed renal stone patients from Jiangxi province Gannan district were randomly selected as the research group(180 cases),and rennal stone patients in non-rare earth exposed were selected as control group(180 cases).The secondary renal stones were removed,including cystine stone,uric acid stone and phosphate stone.There were 173 cases in research group and171 cases in control group.We detected the rare earth elements in stone(μg/g)and blood plasma(mmol/L).The content of rare earth elements in the calculus was detected by inductively coupled plasma atomic emission spectrometry.Detection of rare earth elements in blood plasma by American company PE EAAN-5000 inductively coupled plasma mass spectrometry(ICP-MS)was done.Result:Dysprosium,ytterbium,thulium,gadolinium and erbium in stone in research group were higher than those in control group(P<0.05).Dysprosium,ytterbium,thulium,lutetium,praseodymium and neodymium in plasma in research group were significantly higher than those in control group(P<0.05).But there was no significant difference in lanthanum,cerium,samarium,europium,terbium and holmium between the two groups(P>0.05).Removal of secondary stones for calculus composition analysis,the research group was mainly composed of mixed stones,and the control group was mainly composed of simple calcium oxalate,and the difference was statistically significant(P<0.05).Conclusion:Dysprosium,ytterbium and thulium may be the causes of evoked urinary stone in rare earth exposure population from Jiangxi province Gannan district.
Objective:To investigate the effect of rare earth on the formation of urolithiasis in rare earth exposure population from Jiangxi province Gannan district.Method:The rare earth exposed renal stone patients from Jiangxi province Gannan district were randomly selected as the research group(180 cases),and rennal stone patients in non-rare earth exposed were selected as control group(180 cases).The secondary renal stones were removed,including cystine stone,uric acid stone and phosphate stone.There were 173 cases in research group and171 cases in control group.We detected the rare earth elements in stone(μg/g)and blood plasma(mmol/L).The content of rare earth elements in the calculus was detected by inductively coupled plasma atomic emission spectrometry.Detection of rare earth elements in blood plasma by American company PE EAAN-5000 inductively coupled plasma mass spectrometry(ICP-MS)was done.Result:Dysprosium,ytterbium,thulium,gadolinium and erbium in stone in research group were higher than those in control group(P<0.05).Dysprosium,ytterbium,thulium,lutetium,praseodymium and neodymium in plasma in research group were significantly higher than those in control group(P<0.05).But there was no significant difference in lanthanum,cerium,samarium,europium,terbium and holmium between the two groups(P>0.05).Removal of secondary stones for calculus composition analysis,the research group was mainly composed of mixed stones,and the control group was mainly composed of simple calcium oxalate,and the difference was statistically significant(P<0.05).Conclusion:Dysprosium,ytterbium and thulium may be the causes of evoked urinary stone in rare earth exposure population from Jiangxi province Gannan district.
引文
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8 Najeeb Q,Masood I,Bhaskar N,et al.Effect of BMI and urinary pH on urolithiasis and its composition[J].Saudi J Kidney Dis Transpl,2013,24(1):60-66.
9 郭涛,明星,张岗,等.尿激酶对草酸钙晶体成长和聚集的抑制作用[J].临床泌尿外科杂志,2016,31(7):643-646.
10 Tracy C R,Henning J R,Newton M R,et al.Oxidative stress and nephrolithiasis:a comparative pilot study evaluating the effect of pomegranate extract on stone risk factors and elevated oxidative stress levels of recurrent stone formers and controls[J].Urolithiasis,2014,42(5):401-408.
11 Darisipu M N,Knauf F.An update on the role of the inflammasomes in the pathogenesis of kidney diseases[J].Pediatr Nephrol,2016,31(4):535-544.
12 Chiangjong W,Thongboonkerd V.Calcium oxalate crystals increased enolase-1 secretion from renal tubular cells that subsequently enhanced crystal and monocyte invasion through renal interstitium[J].Sci Rep,2016,6:24064.
13 Wiessner J H,Hasegawa A T,Hung L Y,et al.Mechanisms of calcium oxalate crystal attachment to injured renal collecting duct cells.[J].Kidney Int,2001,59(2):637-644.
14 Hayashi S,Usuda K,Mitsui G,et al.Urinary yttrium excretion and effects of yttrium chloride on renal function in rats[J].Biol Trace Elem Res,2006,114(1-3):225-235.
15 史世鹏,刘春,黄小惠,等.药用醋膏预防大鼠泌尿系结石形成及其机制的初步研究[J].临床泌尿外科杂志,2016,31(7):634-637.
2 Ohnishi K,Usuda K,Nakayama S,et al.Distribution,elimination,and renal effects of single oral doses of europium in rats[J].Biol Trace Elem Res,2011,143(2):1054-1063.
3 卢红宇,欧阳春莲,易志云,等.赣南稀土矿区翼状胬肉流行病学调查及手术[J].中华眼外伤职业眼病杂志,2013,35(3):180-182.
4 武婧,王素华,余艳琴,等.稀土氧化钕颗粒物致大鼠肺损伤相关性研究[J].中国职业医学,2013,40(5):389-353.
5 李冬梅,黄可欣.长期服用低剂量硝酸镧对大鼠肾脏的影响[J].军医进修学院学报,2008,29(5):418-419.
6 丁冶春,蓝海英,郭有,等.钇在大鼠组织器官的分布与蓄积特征及对从业人员脂代谢的影响[J].赣南医学院学报,2015,35(6):840-843.
7 Kizivat T,Smoli c'M,Mari c'I,et al.Antioxidant pretreatment reduces the toxic effects of oxalate on renal epithelial cells in a cell culture model of urolithiasis[J].Int J Environ Res Public Health,2017,14(1).pii:E109.
8 Najeeb Q,Masood I,Bhaskar N,et al.Effect of BMI and urinary pH on urolithiasis and its composition[J].Saudi J Kidney Dis Transpl,2013,24(1):60-66.
9 郭涛,明星,张岗,等.尿激酶对草酸钙晶体成长和聚集的抑制作用[J].临床泌尿外科杂志,2016,31(7):643-646.
10 Tracy C R,Henning J R,Newton M R,et al.Oxidative stress and nephrolithiasis:a comparative pilot study evaluating the effect of pomegranate extract on stone risk factors and elevated oxidative stress levels of recurrent stone formers and controls[J].Urolithiasis,2014,42(5):401-408.
11 Darisipu M N,Knauf F.An update on the role of the inflammasomes in the pathogenesis of kidney diseases[J].Pediatr Nephrol,2016,31(4):535-544.
12 Chiangjong W,Thongboonkerd V.Calcium oxalate crystals increased enolase-1 secretion from renal tubular cells that subsequently enhanced crystal and monocyte invasion through renal interstitium[J].Sci Rep,2016,6:24064.
13 Wiessner J H,Hasegawa A T,Hung L Y,et al.Mechanisms of calcium oxalate crystal attachment to injured renal collecting duct cells.[J].Kidney Int,2001,59(2):637-644.
14 Hayashi S,Usuda K,Mitsui G,et al.Urinary yttrium excretion and effects of yttrium chloride on renal function in rats[J].Biol Trace Elem Res,2006,114(1-3):225-235.
15 史世鹏,刘春,黄小惠,等.药用醋膏预防大鼠泌尿系结石形成及其机制的初步研究[J].临床泌尿外科杂志,2016,31(7):634-637.