新月体肾小球肾炎的尿沉渣谱及其临床意义  

Clinical significance of urine sediment spectrum analyses in crescentic glomerulonephritis

作　　者：李惊子[1] 陈育青[1] 王素霞[2] 庞维[1] 鄂洁[1] 刘颖[1] 秦小琪[3] 

机构地区：[1]北京大学第一医院肾内科,100034 [2]北京大学第一医院电镜室,100034 [3]北京大学第一医院统计室,100034

出　　处：《中华医学杂志》2010年第28期1978-1981,共4页National Medical Journal of China

摘　　要：目的探讨尿沉渣谱检查对于新月体肾小球肾炎诊断的临床意义及尿“特殊细胞”作为早期标志物的可能性。方法北京大学第一医院35例经肾活检病理诊断新月体肾小球。肾炎的患者，采用相位差显微镜检测肾活检日晨尿，归纳尿沉渣谱特点，与肾脏病理进行相关性分析。免疫组织化学法以podocalyxin抗体检测肾组织和尿足细胞。结果新月体肾炎尿沉渣谱呈明显血尿，部分白细胞尿，多管型尿，半数以上病例有“特殊细胞”尿，提示肾脏急性增殖性病变。新月体早、中、晚各期，尿“特殊细胞”检出率分别为75％、41．2％和0，提示该3期间“特殊细胞”存在差异趋势。任选部分9／35病例证实其中8例尿中有足细胞。结论新月体肾炎时，尿沉渣谱和病理损伤的程度、时期有关；尿中发现“特殊细胞”或足细胞有助于新月体肾炎的早期诊断和对疾病活动性的评估。Objective To explore whether the analyses of urine sediment spectrum contribute to the diagnosis of crescentic nephritis and whether special cells in urine could be a biomarker for the early stage crescentic nephritis. Methods Thirty-five patients diagnosed as crescentic nephritis with renal biopsy were recruited. The phase-contrast microscope was used to observe the early morning urine and offer comprehensive descriptions of urine sediment spectrum. And podocalyxin antibody was utilized to detect podocytes in urine and renal specimens by immunohistochemistry. Results Marked bematuria and casts were present in the urine of crescentic nephritis and ＂special cells＂ appeared in over 50% subjects. The detection rates of ＂special cells＂ were 75% , 41% and 0 respectively in early, middle and later stages of crescentic nephritis. Podocytes were identified in the urine of 8/9 subjects. Conclusions The urine sediment spectrum contributes to the diagnosis of crescentic nephritis. And special cells in urine are helpful to gauge the stage of crescentic nephritis.

关 键 词：血尿 尿分析 足细胞 新月体肾小球肾炎 

分 类 号：R692.3[医药卫生—泌尿科学]