创建一个简单而实用的尿红细胞形态诊断新标准

目的以环形、靶形、芽孢形作为肾小球性血尿的特征红细胞，采用普通光学显微镜观察已被确诊为肾小球疾病患者尿中特征变形红细胞的比值，寻找一个主观性小而又实用的肾小球性血尿的诊断标准。方法首先确定在肾小球性血尿中敏感性高且容易辨认、主观性小的特征性变形红细胞，然后分析经过肾穿刺病理确诊的150例患者的特征变形红细胞的百分比，分成多个截断点，分别计算敏感度（Se）和特异度（Sp）绘制ROC曲线，并计算曲线下面积。结果肾小球性血尿患者特征变形红细胞数多≥30％，而非肾小球性血尿患者特征变形红细胞数多〈10％。以特征变形红细胞数≥30％为标准，诊断为肾小球性血尿，敏感性84％，特异性97％，ROC曲线下面积0．976，同时显著缩小了混合型血尿的范围。结论以环形、靶形、芽孢形作为肾小球性血尿的特征红细胞，对诊断肾小球性血尿简单、易行，具有较好的实用价值。

Objective To seek a small subjective and functional diagnostic standard for glomerular hematuria, under the observation of the ration of red blood cells with deformed features, such as ring, target, spore-shaped red blood cells, which were found out from the urine of the patients with glomerular disease through ordinary optical microscopy. Methods First, the feature-deformed red blood cells which were highly sensitive and easy to identify throughout glomerular hematuria were found out and then the percentage of feature-deformed red blood cells were analysed from the 150 diagnosed patients after renal biopsy, they were divided into a plurality ofcut-offpoints, sensitivity （ Se ） and specificity （ Sp ） were calculated and the ROC curve was draw, finally calculated the area under the curve. Results The number of red blood cells with the characteristics of deformation in patients who got glomerular hematuria was mostly~〉30%, while in patients without glomerular hematuria was mostly〈10%, by the standards of the number of red blood cells with the characteristics of deformation in patients who got glomerular hematuria was mostly〉30%, we could call it glomerular hematuria, among them, Se was 84%, and specificity was 97%, area of ROC was 0.976, meanwhile, we could decrease the opportunity of getting mixed hematuria. Conclusion We take ring, target, spore-shaped red blood cells as deformed characteristics, that is qultely practical for diagnosing glomerular hematuria.