尿渗透压对尿红细胞位相检查的影响  

Effects of different urine specimens on urinary red blood cell phase

作　　者：万震[1] 朱康宁[1] 岳波[1] 李泮 邢志杰[1] 王洪新[1] 荆楠[1] 

机构地区：[1]河南省人民医院,郑州450003

出　　处：《医药论坛杂志》2015年第2期9-11,共3页Journal of Medical Forum

基　　金：河南省卫生厅科技攻关项目(卫生厅201203114)

摘　　要：目的探讨尿渗透压对尿红细胞位相检查诊断肾小球性血尿的影响。方法入选有血尿的患者226例,确诊为肾小球病变的120例,非肾小球病变的106例。用相差显微镜观察渗透压不同的晨尿、新鲜尿标本中的红细胞形态。以尿红细胞>8000个/ml,其中畸形红细胞>70%;G1红细胞≥5%,作为肾小球性血尿的诊断标准,评估不同渗透压下尿红细胞位相检查的准确性。结果肾小球疾病组晨尿的渗透压显著高于新鲜尿渗透压(t=44.36,P<0.05)。以临床诊断为金标准,红细胞位相检查判断血尿来源的准确率,新鲜尿(88.3%)标本高于晨尿(75.8%)标本(χ2=6.38,P<0.05)。非肾小球疾病组晨尿与新鲜尿标本渗透压比较有统计学差异(t=92.61,P<0.05),红细胞位相检查新鲜尿标本的准确率更高(χ2=9.73,P<0.05)。结论行尿红细胞位相检查时可选择渗透压较低的新鲜尿标本,其在鉴别血尿来源方面准确性更高。Objective To evaluate effects of different urine osmolality on urinary red blood cell phase in the diagnosis of glomerular hematuria. Methods Totally 226 patients with haematuria were examined,including 120 cases with glomerular diseases and 106 cases of non- glomerular disease. Morphology of red cells was examined in urine by phase contrast microscope. The diagnostic standard of glomerular haematuria was red cells 8000 / ml,with deformity red cells 70%and G1≥5%. The accuracy was analyzed. Results In glomerular diseases group,morning urine had a significantly higher urine osmolality than fresh urine（ t = 44. 36,P〈0. 05）. Taking clinical diagnosis as gold standard,the accuracy of urinary red blood cell phase test was 88. 3% in fresh urine specimen,which was higher than that in morning urine（ 75. 8%）（ χ2= 6. 38,P〈0. 05）. While in non- glomerular disease group,morning urine also had a significantly higher urine osmolality than fresh urine（ t = 92. 61,P〈0. 05）. The accuracy of fresh urine specimen was higher（ χ2= 9. 73,P〈0. 05）. Conclusion Fresh urine specimen could be collected when urinary red blood cell phase test is needed. Fresh urine specimen is more accurate in terms of identifying the sources of hematuria.

关 键 词：尿渗透压 尿红细胞位相 血尿 相差显微镜 

分 类 号：R446.1[医药卫生—诊断学]