流行性出血热患者尿液沉渣超活体染色镜检及其临床意义

Staining and microscopic examination of the sediments of urine from patients with epidemic hemorrhagic fever and their clinical significance

用甲苯胺蓝-副品红染液对流行性出血热(EHF)患者65例197份尿液沉渣行超活体染色和镜检,并对部分标本行特异性间接免疫荧光(IF)法染色。结果表明:①本法分辨率高,且简便快速;②尿液中各种细胞及有形成份数量,在EHF前三期较后两期、重症例较轻症例显著增多,若畸形红细胞为主而大量出现,且伴较多的粗短管型与成团出现的肾小管上皮细胞,提示急性肾功衰竭;③尿细胞及有形成份中的包涵体为EHFV所特有,具有确诊意义;④镜下所见膜状物较肉眼所见膜状物出现早,消失晚。提示,在本病ARF发病机理中,除肾缺血、免疫损伤等因素外,肾毒性物质直接作用似不容忽视。本法对EHF诊断、病情观察和预后判断等均具有重要意义。

197 samples of the mine sediments from patients with epidemic hemorrhagic fever (EHF) were stained with toluidine blue-pararoseine and some of the samples were also stained with special immunoflurorescence in the present report, in order to study the cytological changes of the urine sediments in EHF patients. The results showed that the kinds and numbers of the tangible components in urine that were related to the severity of illness in the febrile, hypotensive and oliguric phases of EHF were more than those in the diuretic and convalescent phases. The appearence of abnormal red blood cells in large numbers accompanied by the wide and short casts and the kidney epithelial cells in cluster indicated the occurrence of acute renal failure. It was simultaneously shown that the detections of the viral inclusion bodies and the membrane-like substance in urine were of valuable in diagnosis. The above results suggested that the technique may be helpful for the diagnosis and evalutions of the severity and the prognosis of EHF.