血尿中游离血红蛋白比例鉴别肾小球源性血尿与非肾小球源性血尿的意义

目的:观察血尿中游离血红蛋白占总血红蛋白的比例与肾小球源性血尿和非肾小球源性血尿的关系。方法:用干化学法检测肾小球性疾病组和非肾小球性疾病组血尿中离心尿液的隐血程度和未离心并冰冻处理的尿液的隐血程度,通过不同隐血程度所对应的血红蛋白浓度算出游离血红蛋白的比例。对两组值进行比较。结果:肾小球性疾病组血尿中游离血红蛋白比例为0.54±0.31,非肾小球性疾病血尿中游离血红蛋白比例为0.03±0.04。两组比较差异有显著性(P<0.01)。同时发现游离血红蛋白比例≥0.31诊断肾小球性疾病的符合率为97.5%;游离血红蛋白比例≤0.13诊断非肾小球性疾病的符合率为100%。结论:用血尿中游离血红蛋白比例可作为鉴别肾小球源性血尿和非肾小球源性血尿的指标之一。能否用游离血红蛋白比例≥0.31作为判定肾小球源性血尿的界限和游离血红蛋白比例≤0.13作为判定非肾小球血尿的界限有待进一步大批量的观察研究。

Determination of proportion of free hemoglobin in urine for differentiation of glomerular and non- glomerular diseases

Objective:To study the significance of free hemoglobin proportion in the diagnosis the patients with glomerular diseases and non- glomerular diseases.Methods:Occult blood of supernatant of urine centrifugated was detected with dry chemistry and free hemoglobin proportions were calculated with occult blood grade corresponding hemoglobin concentration. Results:Free hemoglobin proportions in patients with glomerular diseases was considerably higher (P<0.01) than that in patients with non-glomerular diseases.When the rate of free hemoglobin proportion≥0.31 diagnosis accuracy was 97.5% for glomerular diseases while the rate of free hemoglobin properation ≤0.13 diagnosis accuracy non-glomerular diseases was 100% . Conclusions :Free hemoglobin proportion can be used to differentiat glomerular diseases and non-glomerular diseases.