三种尿红细胞检测方法在肾性血尿诊断中的临床应用评价

目的:对肾性血尿(G.N)与非肾性血尿(N.G)进行临床鉴别诊断。方法:尿沉渣镜检为血尿的51例肾性血尿标本和65例非肾性血尿标本分别采用相差显微镜观察尿中红细胞形态。Sysmex UF-1000i全自动尿沉渣分析仪检测尿红细胞均一性和非均性分布;尿红细胞微柱凝胶直接抗人球蛋白法检测被免疫球蛋白致敏的尿红细胞。结果:相差显微镜法特异性为83.0%,敏感性为84.3%;Sysmex UF-1000i全自动尿沉渣分析仪的特异性为66.2%,敏感性为90.2%;尿红细胞微柱凝胶直接抗人球蛋白法的特异性为70.8%,敏感性为86.3%;三种方法联合检测的特异性为70.9%,敏感性为96.1%。Sysmex UF-1000i全自动尿沉渣分析仪检测法与尿红细胞微柱凝胶直接抗人球蛋白法组合,其特异性为73.8%,敏感性为88.2%。结论:三种方法对判断肾性血尿准确性存在差异,以相差显微镜法的特异性最高,两两组合中,相差显微镜法联合尿红细胞微柱凝胶直接抗人球蛋白检测的敏感性最高。

Clinical application evaluation of the detection method of three urine red blood cells in the diagnosis of renal hematuria

Objective To identify and diagnose the renal hematuria(GN) and nonrenal hematuria(N.G).Method 51 samples of renal hematuria and 65 samples of nonrenal hematuria through microscope exam of uric sediment were observed blood cell forms with phase contrast microscope respectively.Sysmex UF-1000i fully automatic urine dreg analyzer was used for testing uniform and non-uniform distribution of urine red blood cells,and urine red blood cell micro-column gel direct-against human globulin method was adopted to detect the urinary red blood cells sensitized by immunoglobulin.Results The specificity of phase contrast microscope method was 83.0%,sensitivity was 84.3%;the specificity of Sysmex UF-1000i fully automatic urine dreg analyzer method was 90.2%,sensitivity was 66.2%;the specificity of urine red blood cell micro-column gel direct-against human globulin method was 86.3%,sensitivity was 90.8%;the specificity of combined test of the three methods was 70.9%,sensitivity was 96.1% the specificity of combination of Sysmex UF-1000i fully automatic urine dreg analyzer test method and urine red blood cell micro-column gel direct-against human globulin method was 73.8%,and the sensitivity was 88.2%.Conclusion The three methods have differences in the accuracy of judging renal hematuria,the specificity of phase contrast microscope method is the highest.The specificity of phase contrast microscope method combined with urine red blood cell micro-column gel direct-against human globulin method is the hightest in the combinations.