尿变形红细胞新分类法在肾小球轻微病变中的应用

Applications of a new classification of dysmorphic urinary erythrocytes in minor glomerular abnormalities

目的研究尿变形(D)红细胞的一种新分类法在肾小球轻微病变血尿中的应用价值。方法对84例确诊为肾小球轻微病变患者和73例非肾小球疾病患者的血尿标本应用相差显微镜观察进行分类,同步检测尿蛋白及管型。结果在84例肾小球轻微病变血尿中,经242次检测红细胞,以D1+D2≥5%为诊断标准的敏感性、特异性、准确性分别为49.6%、100%、67.4%,以新分类法(D1+D2≥5%或D3≥20%)为诊断标准的敏感性、特异性、准确性分别为90.1%、98.5%、93.0%。D1+D2≥5%组与D1+D2<5%而D3≥20%组间尿蛋白、细胞管型检出率有统计学差异(0.01<P<0.05),而透明管型、脂肪管型检出率无统计学差异(P>0.05)。结论D1+D2≥5%或D3≥20%是诊断肾小球轻微病变血尿的敏感方法。

Objective To study the clinical significance of applications of a new classification of dysmorphic urinary erythrocytes in minor glomerular abnormalities.Methods 84 cases of minor glomerular abnormalities with hematuria and 73cases of non-glomemlar diseases with hematuria were analyzed by contrast microscope, and proteinuria and casts in urinary sediment were detected simuhaneously. Results In 84 cases of minor glomemlar abnormalities with hematuria, the sensitivity, sensitivity and accuracy of new classification of glomerular hematuria （D1 ＋ D2≥ 5 % or D3≥ 20% ） were 90.1%, 98.5 % and 93.0% respectively, much higher than the classification with DI ＋ D2≥5% only.Conclusion The new classification was a sensitive method to diagnose glomemlar hematuria in patients with minor glomerular abnormalities.