尿红细胞形态、容积曲线及血红细胞容积曲线鉴别血尿来源

Source identification of hematuria by urinary erythrocyte morphology,urinary erythrocyte volume curve and red blood cell volume curve

目的探讨尿红细胞形态、容积曲线及血红细胞容积曲线联合检验在鉴别血尿来源中的临床价值。方法采用AVE-763尿沉渣分析仪对138例非肾性血尿及33例肾性血尿观察尿红细胞形态并计算畸形率,再用XT-2000i全自动血细胞分析仪检测尿红细胞及外周血红细胞容积(MCV、RDW)。结果138例非肾性血尿的尿红细胞畸形率为14.7±12.3%,MCV为91.4±13.4fl,RDW为16.4±2.3%,外周血红细胞MCV为79.6±11.3fl,RDW为14.4±1.1%,血MCV/尿MCV为0.89±0.08;33例肾性血尿的尿红细胞畸形率为72.8±10.1%,MCV为63.5±10.1fl,RDW为24.5±6.1%,外周血红细胞MCV为79.1±10.7fl,RDW为14.3±1.0%,血MCV/尿MCV为1.25±0.11,二组相比较,尿红细胞畸形率、MCV、RDW及血MCV/尿MCV有显著性差异(P﹤0.05)。结论尿红细胞形态、容积曲线及血红细胞容积曲线联合检验提高了肾病的诊断符合率,更加客观、准确地鉴别血尿来源,值得推广和应用。

Objective To explore the clinical value of urinary erythrocyte morphology, urinary erythrocyte volume curve and red blood cell volume curve in source identification of hematuria. Methods Urine specimens from 138 patients with non-renal hematuria and 33 patients with renal hematuria were analyzed by AVE-763 urinary sediment analyzer. Peripheral blood samples from the same patients were analyzed by XT-2000i automatic blood cell analyzer. Results For the 138 patients with non-renal hematuria, the deformity rate, MCV and RDW of urinary erythrocyte were 14.7±12.3%, 91.4±3.4fl and 16.4±2.3% respectively. The MCV and RDW of red blood cell were 79.6±11.3fl and 14.4±1.1% respectively. The MCV ratio （MCV of red blood cell / MCV of urinary erythrocyte） was 0.89±0.08. For the 33 patients with renal hematuria, the deformity rate, MCV and RDW of urinary ery- throcyte were 72.8±10.1%, 63.5±10.1fl and 24.5±6.1% respectively. The MCV and RDW of red blood celt were 79.1±10.7fl and 14.3＋1% respectively. The MCV ratio was 1.25±0.11. In the two groups, the deformity rate, MCV and RDW of urinary erythrocyte, MCV ratio were significantly different（P〈0.05）. Conclusion The diagnostic efficiency could be increased when urinary erythrocyte morphology, urinary erythrocyte volume curve and red blood cell volume curve were combined using. That is worthy promoting and using.