异常形态红细胞百分比法和芽孢状等特殊异常形态红细胞百分比法在小儿肾性血尿诊断中临床价值的对比观察

目的对小儿肾性血尿进行红细胞形态学分析,评价异常形态红细胞百分比法和芽孢状等特殊形态红细胞百分比法在小儿肾性血尿鉴别诊断中的临床价值。方法回顾性对来自首都医科大学附属北京友谊医院的117例非重复性小儿肾性血尿标本红细胞形态检查结果进行分析,比较尿红细胞形态检查两种判断标准的敏感性。结果在肾小球疾病组和对照组,异常形态红细胞占红细胞总数80%的标本百分比分别为62. 5%(73/117)和12. 0%(15/125),差异具有明显统计学意义(P <0. 01);芽孢状红细胞等特殊异常形态红细胞百分比≥30%标本百分比分别为83. 8%(98/117)和8. 0%(10/125),差异具有非常显著性统计学意义(P <0. 01)。明确诊断为肾小球疾病患儿,尿液异常形态红细胞占红细胞总数≥80%百分比显著低于芽孢状红细胞等特殊异常形态红细胞百分比≥30%者(62. 4%,73/117 vs.83. 8%,98/117),差异具有非常显著性统计学意义(P <0. 01)。结论以芽孢状红细胞等特殊异常形态红细胞百分比法作为判断标准对小儿肾性血尿的诊断具有较好的敏感性。

Comparative observation of clinical value of dysmorphic erythrocyte and special dysmorphic erythrocyte such as acanthocyte in diagnosing glomerular hematuria in children

Objective To evaluate the clinical value of dysmorphic erythrocyte and special dysmorphic erythrocyte such as acanthocyte in differential diagnosis of glomerular hematuria in children. Methods The erythrocyte morphology examination results of 117 children with non-repetitive glomerular hematuria were retrospectively analyzed to compare the sensitivity of the two methods. Results The percentage of cases with dysmorphic erythrocytes accounting for ≥80% of the total erythrocytes in glomerular disease group and control group were 62. 4%( 73/117) and12. 0%( 15/125) respectively,the difference was statistically significant( P < 0. 01). The percentage of cases with special dysmorphic erythrocyte such as acanthocytes accounting for ≥30% was 83. 8%( 98/117) and 8. 5%( 10/125) respectively,the difference was statistically significant( P < 0. 01). In 117 children with glomerular diseases,the percentage of urinary dysmorphic erythrocyte accounting for ≥80% was significantly lower than the percentage of special dysmorphic erythrocyte such as acanthocytes accounting for ≥30%( 62. 4%,73/117 vs 83. 8%,98/117),the difference was statistically significant( P < 0. 01). Conclusion The method of special dysmorphic erythrocyte such as acanthocyte has good sensitivity and specificity in the diagnosis of glomerular hematuria in children.