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132例血尿标本红细胞形态及微量白蛋白与免疫球蛋白轻链测定结果分析

ANALYSIS OF ERYTHROCYTE MORPHOLOGY MICRO-ALBUMIN AND IMMUNOGLOBULIN LIGHT CHAIN IN 132 CASES OF HEMATURIA SPECIMENS
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摘要 目的探讨血尿中变形红细胞(erythrocyte RBC)与尿微量白蛋白(micro-albumin,MA)及尿免疫球蛋白轻链(light chain,L)三者间的相关性,以鉴别肾小球性血尿(glomerular hematria,GH)和非肾小球性血尿(non glomerular hematuria,NGH)。方法对132例血尿诊断明确患者进行相差显微镜尿中RBC形态观察、MA和L测定。结果 132例血尿中91例为肾小球性血尿,通过RBC形态观察,以多形性变形RBC改变为主85例占93.4%;41例非肾小球性血尿中,多形性RBC改变仅16例占39.0%,差异有统计学意义(P<0.01);在肾小球性血尿中,变形型RBC阳性伴MA阳性79例占86.8%,MA的单项符合率90.1%;而非肾小球性血尿中的变形RBC假阳性率为39.2%,MA的假阳性率为41.5%,二者有相关性(r=0.729,P<0.01)。L的检出率在肾小球性血尿中为62.6%(57/91),非肾小球性血尿中为58.5%(24/41),二者差异无统计学意义(P>0.05);在肾小球性血尿中,变形RBC和L均阳性52例占57.1%,非肾小球性血尿中的L假阳性24例占58.5%,二者差异无统计学意义(P>0.05)。结论尿RBC形态多形性观察有助于肾小球性血尿与非肾小球性血尿的鉴别;MA检出率肾小球性血尿明显高于非肾小球性血尿,L与尿变形RBC检出对二种血尿的鉴别无明显相关性。 Objective To investigate the correlation among deformed erythrocyte , micor- albumin(MA) and immunoglobulin light chain in hematuria specimens , and to differentiate glomerular hematuria(GH) from non- glomerular hematuria(NGH). Methods A total of 132 patients definitely diagnosed as hematuria were involved in -this study. Tile morphology of erythrocyte in urine was observed under phase contrast microscope and the MA and immunoglobulin light chain in urine were measured. Results In 132 cases of hematuria, 91 cases were GH and 41 cases were NGH. The rate of deformed erythrocyte hematuria was 93.4% (85/91) in GH group, and only 39.0% (16/41) in NGH group,the difference between GH and NGH group was statistically significant( P 〈0.01 ). In GH group, 86.8% cases were deformed erythrocyte hematuria complicated with positive MA, The single coincidence rate of MA was 90.1%. The false positve rate of deformed erythrocyte hematuria and MA were 39.2% and 41. 5% respectively, there was correlation between the above two indexes. The detection rate of immunoglobulin light chain was 62.6% (57/91) in GH group and 58.5% (24/41) in NGH group. There was no significant difference between GH and NGH. In GH group,57.1% (52/91) cases were deformed erythrocyte hematuria complicated with positive immunoglobulin light chain, the false positive rate of immunoglobulin light chain was 58. 5% (24/41) in NGH group, there was no significant difference between the two groups ( P 〉 0.05 ). Conclusion The observation of deformed erythrocyte is helpful to differentiate GH from NGH. The detection rate of MA is significantly higher in GH group than that of NGH group., the difference is statistically significant. There immunoglobulin light chain and deformed erythrocyte detection is no significant correlation between for the differentiation of GH and NGH.
作者 张华
出处 《河北医科大学学报》 CAS 2010年第8期950-952,共3页 Journal of Hebei Medical University
关键词 血尿 红细胞 白蛋白尿 免疫球蛋白类 hematuria erythrocytes albuminuria immunoglobulins
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