肾病患者尿液红细胞荧光定位方法及应用

Value of urine RBC immunofluorescence in differentiate diagnosis of nephropathy

目的 :建立免疫荧光方法对尿中红细胞膜上进行荧光定位 ,以区别肾性与非肾性血尿 .方法 :以荧光标记兔抗人免疫球蛋白为抗体 ,采用直接免疫荧光染色法检测肾病患者1 76例 ,非肾病患者 1 6 3例 ,观察尿中红细胞膜上的荧光着色程度 ,从而建立红细胞荧光定位检查方法 ,用于肾病的鉴别诊断 ,同时做尿沉渣形态学对比检查 .结果 :用荧光标记的兔抗人Ig抗体 (抗IgA ,IgG ,IgE及IgM抗体 )分别对肾病组患者1 76例尿中红细胞上 4种Ig抗体染色检查 ,总阳性率为97.2 % (1 71 / 1 76 ) ;形态学检查总阳性率为 6 4 .2 % (1 1 3/ 1 76 ) ;对非肾病患者 1 6 3例尿中红细胞上Ig染色检查 ,总阳性率为1 .2 % (2 / 1 6 3) .结论 :直接免疫荧光染色法是在尿沉渣检查的基础上发展的一种新的染色法 ,免疫荧光染色方法特异性强 。

AIM: To establish an immunofluorescence technique to differentiate the origin of hematuria. METHODS: Urine sediment was colored by direct immunofluorescence using fluorescence labeled rabbit anti human immunoglobulin. The origin of RBC was distinguished by the brightness of fluorescence in the membrane and the morphology of RBC was observed at the same time. RESULTS : The total positive rate of immunofluorescence was 97.2% in 176 urine samples of nephropathy group and 1.2% in 163 samples of non nephropathy group. The positive rate of morphological test was 64.2% in nephropathy group. CONCLUSION: Direct immunofluorescence is a new method in urine sediment test. This method, specific in the differentiate diagnosis of nephric or non nephric hematuria, can be used to enhance the diagnostic rate of nephric hematuria.