尿单核细胞计数在肾小球疾病鉴别诊断中的意义

The clinical value for differential diagnosis of glomerular disease by testing urinary mononuclear cells in patients with hematuria

目的 探讨尿单核细胞计数作为一种非创伤性检查手段判断肾炎细胞增生程度的临床价值。方法 利用流式细胞仪测定２７ 例肾性血尿患者尿巨噬细胞计数及尿巨噬细胞／Ｔ淋巴细胞比值，并与肾活检结果进行对照。结果 ２７ 例肾性血尿患者经肾活检分为不同类型的增生性肾炎组（１９ 例） 和非增生性肾炎组（８ 例），发现尿巨噬细胞计数在增生性肾炎组明显高于非增生性肾炎组（ Ｐ＜ ０－００１），并且尿巨噬细胞计数随着肾炎增生程度的加重而明显升高（Ｐ＜０－０５）；同时观察到增生明显的血尿患者，尿巨噬细胞／Ｔ淋巴细胞比值升高；非增生性肾炎组尿巨噬细胞／Ｔ淋巴细胞比值无明显改变。结论 尿巨噬细胞计数及尿巨噬细胞／Ｔ淋巴细胞比值可作为临床判断肾炎细胞增生程度和肾性血尿预后的一种非创伤性诊断指标。

Objective To evaluate the clinical significance of urinary mononuclear cells as a noninvasive differential diagnosis means of glomerular disease.Methods The number of urinary macrophages and T-lymphocytes in fresh urine samples from 27 patients with hematuria were measured by flow cytometry, and compared with the results of renal biopsy.Results Urinary macrophage counts and the ratio of urinary macrophage counts to T lymphocyte counts increased significantly in proliferative glomerular disease but not in patients with non-proliferative glomerular disease.Conclusion Urinary macrophage counts and macrophage T lymphocyte ratio may provide useful information in evaluating the degree of renal cell proliferation and the prognosis of disease.