尿标本种类对尿红细胞位相检查的影响

Effects of different urine specimens on urinary red blood cell phase

目的探讨晨尿、随机尿、新鲜尿对尿红细胞位相检查诊断肾小球性血尿的影响。方法入选有血尿的患者108例,确诊为肾小球病变的62例,非肾小球病变的46例。用相差显微镜观察晨尿、随机尿、新鲜尿标本中的红细胞形态。以尿红细胞>8 000个/ml,其中畸形红细胞>70%;G1红细胞≥5%,作为肾小球性血尿的诊断标准,评估不同标本行尿红细胞位相检查的灵敏度、特异度和准确性。结果晨尿、随机尿、新鲜尿标本诊断肾小球疾病的灵敏度分别为72.6%、80.6%和87.1%,晨尿灵敏度低于新鲜尿标本(P<0.05);特异度分别为78.2%、89.1%和93.5%,晨尿特异度低于新鲜尿标本(P<0.05);准确性分别为75%,84.3%和89.8%。结论新鲜尿标本在鉴别血尿来源方面更具优势,行尿红细胞位相检查应尽可能采集这种标本。

Objective To evaluate effects of different urine specimens on urinary red blood cell phase in the diagnosis of glomerular hematuria. Methods Totally 108 patients with haematuria were examined, including 62 cases with glomerular diseases and 46 cases of non - glomerular disease. Morphology of red cells was examined in urine by phase contrast microscope. The diagnostic standard of glomerular haematuria was red cells 〉 8000/ml, with deformity red cells 〉 70% and G1 ~〉5%. The sensitivity, specificity and accuracy were analyzed. Results The sensitivity of morning urine, random urine and fresh urine were 72. 6% , 80. 6% and 87.1% , respectively. The sensitivity of morning urine was lower than fresh urine （P 〈0. 05）. The specificity were 78.2% , 89. 1% and 93.5% , respectively. The specificity of morning urine was lower than fresh urine （P 〈0. 05）. The accuracy were 75%, 84. 3% and 89. 8% , respectively. Conclusion Fresh urine specimen has more advantages in terms of identifying the sources of hematuria. Fresh urine specimen should be collected when urinary red blood cell phase test is needed.