球形小红细胞不均一性血尿的临床意义分析

目的探讨球形小红细胞不均一性血尿的临床意义。方法回顾性地对213例首都医科大学附属北京友谊医院非重复性球形小红细胞不均一性血尿标本的患者科室来源、临床初步诊断进行统计分析;比较临床确诊的108例肾小球疾病组和63例泌尿系感染组尿白细胞镜检、尿蛋白检查和肾功能等检查结果的差异。结果 213例标本来源主要为肾内科门诊(33.80%,72/213)、泌尿科门诊(21.60%,46/213)、肾内科病房(16.43%,35/213);197例明确诊断者以原发性肾小球疾病和泌尿系感染最为常见,分别占40.38%(86/213)和29.58%(63/213)。肾小球疾病组红细胞平均前向散射光强度(RBC-MFsc)、尿70%红细胞前散射光强度(RBC-P70 Fsc)和红细胞前散射光分布宽度(RBCFsc-DW)分别为(55.5±16.3)、(55.2±16.5)、(35.9±13.5) ch,泌尿系感染组分别为(57.2±17.2)、(57.4±16.8)、(35.2±13.1) ch,两组比较,差异无统计学意义(P>0.05)。肾小球疾病组尿干化学蛋白检查阳性率和24 h尿蛋白定量阳性(≥0.15 g/24 h)分别为95.37%(103/108)和80.56%(87/108),均显著高于泌尿系感染组(34.92%,22/63和4.76%,3/63),差异具有明显统计学意义(P<0.01);肾小球疾病组尿白细胞镜检(≥5/HP)阳性率显著低于泌尿系感染组(24.07%,26/108 vs.87.30%,55/63),差异具有明显统计学意义(P<0.01)。结论球形小红细胞不均一性血尿疾病来源广泛,结合尿白细胞镜检、尿蛋白检查等指标对其来源鉴别具有重要作用。

Analysis of clinical significance of spheric small red blood cell heterogeneous hematuria

Objective To explore the clinical significance of spheric small red blood cell heterogeneity hematuria.Methods The source and clinical diagnosis of 213 cases of non repetitive spheroid red blood cell heterogeneous hematuria collected from Beijing Friendship Hospital,Capital Medical University was retrospectively analyzed;the differences of the results of urine cell examination,urine protein test and renal function between 108 glomerular disease cases and 63 urinary tract infection cases were compared.Results The 213 specimens were mainly from the outpatient department of nephrology(33.80%,72/213),the outpatient department of urology(21.60%,46/213),and nephrology ward(16.43%,35/213);in 197 cases with definite diagnosis,the most common diagnoses were primary glomerulopathy and urinary tract infection,accounting for 40.38%(86/213)and 29.58%(63/213)respectively.The mean forward scattering intensity of RBC(RBC-MFsc),urine70% RBC forward scattering light intensity(RBC-P70 Fsc)and distribution width of red blood cell forward scattering light(RBC-Fsc-DW)of the glomerular disease group were(55.5±16.3),(55.2±16.5)and(35.9±13.5)ch respectively,and(57.2±17.2),(57.4±16.8)and(35.2±13.1)ch of the urinary tract infection group.There was no significant difference between the two groups(P>0.05).The positive rate of urine protein determined by dry chemical method and urine protein quantitation in 24 h(>0.15 g/24 h)in the glomerular disease group were 95.37%(103/108)and 80.56%(87/108),respectively,which were significantly higher than those in the urinary tract infection group,34.92%(22/63)and 4.76%(3/63)(P<0.01).The positive rate of leukocyte microscopy(>5/HP)in the glomerular disease group was significantly lower than that in the urinary tract infection group(24.07%,26/108 vs.87.30%,55/63,P<0.01).Conclusion The spheric small red blood cell heterogeneous hematuria has a wide range of sources,and it is important to identify the source of the disease in combination with leukocyte microscopic examination and urine protein examination.