新型尿红细胞参数在各型肾小球肾炎临床应用研究 - 中华医学会.DOC

?论著? 新型尿红细胞参数在各型肾小球肾炎诊断中的临床价值 平牧野 李莉 邓新立 丛玉隆 [摘要] 目的 探讨新型尿红细胞参数在不同病理类型的肾小球肾炎中的临床应用价值 方法 用AVE-764尿沉渣分析仪分别检测不同病理类型的原发性和继发性肾小球性肾炎患者尿液中芽孢红细胞百分率和尿红细胞大小-形状位相图的异同 结果 原发性肾小球肾炎和继发性肾小球肾炎患者尿中均可出现芽孢形红细胞。肾小球肾炎患者尿红细胞大小-形状位相图可呈横条形、倒三角形、拖尾形。前两种多见于原发性肾小球肾炎，拖尾形多见于继发性肾小球肾炎 结论 肾小球肾炎患者芽孢形红细胞百分率较高时常为原发性肾小球肾炎，结合尿红细胞位相图可对不同病理类型的肾小球肾炎的鉴别诊断有一定的参考价值。 [关键词] 全自动尿沉渣分析仪；芽孢红细胞百分率；红细胞位相；肾小球肾炎 The clinical significance of new urine red blood cell parameter in different kinds of glomerulonephritis Ping Muye, Li Li, Deng Xinli, Cong Yulong. Department of Clinical Laboratory in South Building. Chinese PLA General Hospital．Beijing 100853, China Corresponding author：Cong Yulong, Email：yulongc@263.net [Abstract] Objective To investigate the clinical value of using the fully automatic urine cell analyzer in discriminating different pathology types of glomerulonephritis. Methods The change of the primary glomerulonephritis and secondary glomerulonephritis urine in the percentage of acanthocytes, the size of RBC, the shape of RBC were detected by AVE-764 fully automatic urine cell analyzer. Results Acanthocytes can be found in both primary glomerulonephritis and secondary glomerulonephritis. The picture of size-shape phase are classified as strip-type, inverted triangle-type and hanging tail-type. Strip-type and inverted triangle-typenormally present in primary glomerulonephritis, hanging tail-type is common in secondary glomerulonephritis. Conclusion High acanthocytes percentare most common inprimary glomerulonephritis, going with the size and shape of RBC can be useful in the differential diagnosis in different pathology types of glomerulonephritis. [Key words] Fully automatic urine cell analyzer; Percentage of acanthocytes; RBC phase; Glomerulonephritis. 肾小球肾炎可分为原发性肾小球肾炎和继发性肾小球肾炎，前者病变原发于肾小球，包括新月体性肾小球肾炎、系膜增生性肾小球肾炎（IgA型和非IgA型）、膜性肾病及局灶节段性肾小球硬化等；后者伴随全身疾病，包括狼疮性肾炎、过敏性紫癜肾炎、糖尿病肾病等【1】。二者均可出现肾性血尿，且畸形红细胞百分率多有交叉【2】。目前检测肾性血尿的方法包括尿红细胞形态学检查、红细胞容积分布曲线等【3】。近年来伴随尿红细胞位相技术的发展，红细胞大小