相差显微镜和UF-100联合检测鉴别血尿来源

Identification of hematuria by combination of phase contrast microscope of Sysmex UF-100 cytometer

目的探讨相差显微镜和UF-100联合检测在鉴别肾性与非肾性血尿中的价值。方法用相差显微镜和UF-100联合检测105例不同来源血尿标本的尿RBC数、尿RBC形态及尿RBC平均前向闪射光强度(RBC-MFsc)等。结果70例肾性血尿尿RBC数通常<500/μl,尿RBC畸形率84%;当RBC-MFsc≤70ch(Channel)时,敏感性90.2%,特异性83.6%,诊断符合率92.8%。35例非肾性血尿的主要特点是:尿RBC数通常>500/μl,尿RBC畸形率14%;RBC-MFsc通常>80ch。结论联合检测分析尿RBC数、尿RBC形态及RBC-MFsc等指标能客观、准确地鉴别和诊断血尿来源。

Objective To evaluate the values of combined detection for distinguishing glomerular hematuria from nonglomerular hematuria by phase contrast microscope with Sysmex UF-100 automated flow cytometer.Methods The count and morphology of urinary red cell (RBC) in 105 urine samples from hematuria patients were measured by phase contrst microscope and urinary RBC-mean forward scattered light intensity (RBC-MFsc) were measured by Sysmex UF-100 automated flow cytometer simultaneously.Results In 70 patients with glomerular hematuria the number of urinary red cells was usually less than 500/μl and the percentage of deformed red cells was 84%.When the cut-off value of RBC-MFsc was defined as less than 70 ch for glomerular hematuria,the sensitivity was 90.2%, specificity was 83.6% and accuracy was 92.8%.In 35 patients with nonglomerular hematuria the number of urinary red cells was more than 500/μl,the percentage of deformed red cells was 14% and RBC-MFsc was more than 80 ch.Conclusion The combined examination including quantity,morphology and MFsc of urinary red cells may be able to disclose and diagnose the source of hematuria more objectively and accurately.