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分析.PDFVIP

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分析 摘要：目的探讨全自动尿沉渣分析仪中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-763 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- 形态位相图的变化。结果原发性肾小球肾炎和继发性肾小球肾炎患者尿中均出现 芽孢形红细胞,原发性肾小球肾炎患者尿中芽孢红细胞百分率常在 10%以上。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，同时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 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-763 fully automatic urine cell analyzer. [Results]Acanthocytes can be found in both primary glomerulonephritis and secondary glomerulonephritis, the percentage of acanthocytes of primary glomerulonephritis usually over 10%. 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、形态、 色度等新参数的应用,并在判断血尿来源。【4-5】如需进一步明确肾性血尿患者 1 的病理类型，肾活检为必要措施。笔者应用AVE-763 全自动尿沉渣分析仪对原发 性、