测定尿红细胞平均体积和分布曲线鉴别血尿来源的临床价值

目的观察尿红细胞平均体积（ＭＣＶ）和尿红细胞分布曲线鉴别血尿来源和性质。方法用ＣＯＵＬＴＥＲ－ＪＴ全自动血球计数仪检测４０例肾小球性血尿、４０例非肾小球性血尿ＭＣＶ和分布曲线。结果肾小球肾炎ＭＣＶ为６１±１４ｆｌ,非肾小球肾炎ＭＣＶ为８９±１８ｆｌ,以ＭＣＶ＜８０ｆｌ鉴别为肾小球性血尿,敏感性和特异性分别为９７．５％和８８．２％。分布曲线的特点不同,峰值差异很大。结论测定尿ＭＣＶ及分布曲线对鉴别血尿来源和性质有重要意义。     

Urethral hemangioma: Laser treatment

Urethral hemangioma is a rare cause of hematuria for which variousmodalities of treatment have been used. We report a young patient, whopresented with hematuria and in whom urethrocystoscopy showed multiplehemangiomas in penile urethra. These were fulgurated successfully withNd-YAG laser. This revised version was published online in August 2006 with corrections to the Cover Date.     

中医药治疗血尿的临床体会

针对肾脏疾病血尿病程长、症情复杂、兼症多和易反复等特点，结合医案介绍了沈庆法教授运用中医药治疗血尿的临床经验和用药体会。     

Hematuria duration does not predict kidney function at 1 year in ANCA-associated glomerulonephritis

Objectives

Hematuria is considered a marker of active renal disease in ANCA-associated glomerulonephritis (ANCA-GN) with induction immunosuppression often continued until hematuria has resolved. We aim to determine whether longer hematuria duration is associated with lower estimated glomerular filtration rate (eGFR) at 1 year.

Methods

We conducted a retrospective study of 55 patients with biopsy-proven ANCA-GN. Linear regression models were constructed to determine predictors of eGFR at 1 year. The primary exposure was hematuria (>5 rbc/hpf) duration, defined as <90 days vs. ≥90 days following renal biopsy. Covariates included age, gender, ANCA type, baseline eGFR, and baseline proteinuria.

Results

Mean age at diagnosis was 58 years (53% male, 80% Caucasian, 38% PR3-ANCA, and 45% MPO-ANCA). At baseline, all patients had hematuria, 95% had proteinuria, and mean serum creatinine was 3.1 [standard deviation (SD) = 2.3] mg/dL. Overall, 93% were treated with steroids in combination with either cyclophosphamide or rituximab. Mean hematuria duration was 92 (SD = 77) days with 34 (62%) patients having hematuria resolution within 90 days. Older age and lower baseline eGFR were associated with lower eGFR at 1 year (p = 0.03 and p < 0.001, respectively). Hematuria resolution (<90 days vs. ≥90 days) was not predictive of eGFR at 1 year (p = 0.93).

Conclusions

In ANCA-GN, hematuria duration does not predict eGFR at 1 year. Our findings provide support that among individuals who are otherwise considered to be in clinical remission, the persistence of hematuria should not delay transition from induction to maintenance immunosuppression.     

Choriocarcinome gestationnel révélé par une métastase rénale

Gestational choriocarcinoma (GC) belongs to a group of gestational trophoblastic tumors. This rare tumor has a great metastatic potential and thus requires an early and adapted treatment. Herein We report a case of GC in a 35-year-old patient who presents with hematuria from a renal metastasis. Clinical improvement was noted after nephrectomy and chemotherapy. This observation underlines the importance of the dosage of the beta-HCG and the polymorphic clinical presentation of gestational choriocarcinoma.     

1200名白族成年人体检单次尿液和肾功能检查结果分析及临床意义

目的:通过分析健康体检人群的检查结果 ,了解云南白族成年人尿检和肾功能检查异常的情况,为中国西南地区慢性肾脏病(chronic kidney disease,CKD)防治提供流行病学依据。方法:回顾性收集并分析2019年1月至12月于云南省大理白族自治州剑川县人民医院体检中心进行常规体检的白族成年人群的尿常规及肾功能检查结果,使用CKD流行病合作工作组(CKD Epidemiology Collaboration,CKD-EPI)公式计算肾小球滤过率(glomerular filtration rate,GFR)。统计体检人群尿检异常情况及肾功能结果,比较并分析不同性别及年龄段之间结果的差异性。结果:本研究共纳入健康体检人群1 200名,均为白族,平均年龄(41.64±11.55)岁,其中男性716名(59.7%)。共有366例(30.5%)体检者出现尿检异常,包括300例(25.0%)镜下血尿以及113例(9.4%)蛋白尿。女性血尿检出率显著高于男性(35.9%比17.6%,χ²=51.88,P<0.001),而男性蛋白尿检出率显著高于女性(11.7%比6.0%,χ²=11.15,P<0.001)。87.3%体检者GFR≥90 mL/(min·1.73m²),GFR<60 mL/(min·1.73m²)体检者仅6例(0.5%)。线性相关分析提示,GFR与年龄呈负相关(r=-0.655,P<0.001)。结论:健康体检是筛查肾脏疾病的重要途径。云南地区白族成年人尿常规及肾功能检查异常率较高,需要引起临床医师重视。     

肾炎清片对无症状性血尿患者IL-6和VEGF水平的影响

目的 探讨肾炎清片对无症状性血尿患者IL-6和VEGF水平的影响.方法 将76例临床诊断为无症状性血尿患者随机分为治疗组和对照组各38例,对照分析肾炎清片治疗前和治疗后无症状血尿患者的IL-6和VEGF的水平.结果 肾炎清片治疗组无症状性血尿患者的IL-6和VEGF的水平较对照组明显降低,结果显示组间的差异具有统计学意义(P＜0.05).结论 肾炎清片能够改变无症状性血尿患者IL-6和VEGF的水平,可能对无症状性血尿患者血尿症状的改善具有一定的作用.