不规则管型的形态观察与临床意义  

Morphological observation of irregular cast and its clinical value

作　　者：卢佩[1] 丁振若[1] 郑善銮[1] 郝晓柯[1] 

机构地区：[1]第四军医大学西京医院/全军临床检验医学中心,陕西西安710032

出　　处：《检验医学与临床》2014年第11期1501-1503,共3页Laboratory Medicine and Clinic

摘　　要：目的检测尿沉渣涂片中的一种特殊病理管型,将其命名为不规则管型(irregular cast),对其在不同疾病中的阳性率进行分析研究,探讨其在泌尿系感染中的诊断意义。方法观察564例泌尿系疾病患者的尿沉渣涂片中不规则管型检出率,并通过荧光染色与瑞-姬染色方法对管型的类别进行判定,同时对中层移行上皮、表层移行上皮、白细胞等成分阳性率作对照比较。结果不规则管型在上泌尿系感染患者尿液中易见,特别是有1年以上感染史的患者。急性肾盂肾炎患者尿液中阳性率为63.4%,慢性肾盂肾炎患者尿液中阳性率为83.3%,肾结石患者尿液中不规则管型阳性率为8.1%,肾小球肾炎患者尿液中不规则管型阳性率为5.8%,膀胱炎、尿道炎、前列腺炎、肾囊肿患者尿液中未见。急性肾盂肾炎和慢性肾盂肾炎患者尿液中不规则管型阳性率与其他各类患者比较,差异有统计学意义(P<0.05)。结论不规则管型是一种特殊类型的管型,在形态上比中层移行上皮细胞更易识别,对上泌尿系感染有重要诊断意义,同时对感染性肾脏损伤有重要的临床作用。Objective To detect a special pathological cast named irregular cast oi Urine sediments,investigate the positive rate of irregular cast in different diseases and investigate the diagnostic significance in urinary tract infection. Methods The irregular cast were examined in the urinary sediments of 564 patients with the urinary system diseases. The fluorescent staining and the Giemsa staining were used for determining the types of the cells. Meanwhile, Middle transitional epithelium, Surface transitional epithelium and the number of leucocytes were treated as the control. Results Irregular cast is easy to be seen in the urinary sediments of patients with urinary tract infection,especially who has this disease more than one year. The positive rate was 63.4% in the acute pyelonephritis,83.3% in the chronic pyelonephritis, 8.1% in the renal calculi, 5.8% in the Glomerulonephritis. No Irregular cast was found in the urines of cystitis, urethritis, prostatitis, and renal cyst. The positive rate of Irregular cast in the acute pyelonephritis and the chronic pyelonephritis was significantly higher than those in the other groups（P〈0.05）. Conclusion The irregular cast is a special cast,is easier to be identified than Middle transitional epithelium. It plays an important role in diagnosising the upper urinary tract infection and the infectious kidney damage.

关 键 词：不规则管型 移行上皮细胞 泌尿道感染 肾盂肾炎 

分 类 号：R322.41[医药卫生—人体解剖和组织胚胎学]