检验医学 ›› 2017, Vol. 32 ›› Issue (7): 582-585.DOI: 10.3969/j.issn.1673-8640.2017.07.006

• 临床应用研究_论著 • 上一篇    下一篇

尿红细胞形态判断标准探究

刘金祥, 丁勇, 曹翠云, 潘妍   

  1. 中国医科大学绍兴医院肾内科,浙江 绍兴 312030
  • 收稿日期:2016-05-03 出版日期:2017-08-08 发布日期:2017-08-09
  • 作者简介:null

    作者简介:刘金祥,男,1962年生,学士,主任医师,主要从事尿红细胞形态学研究。

Standard for judging the morphology of urinary red blood cells

LIU Jinxiang, DING Yong, CAO Cuiyun, PAN Yan   

  1. Department of Nephrology,Shaoxing Hospital of China Medical University,Shaoxing 312030,Zhejiang,China
  • Received:2016-05-03 Online:2017-08-08 Published:2017-08-09

摘要:

目的 寻找一个主观性小而又实用的肾小球性血尿的诊断标准。方法 首先采用普通光学显微镜确定特征变形红细胞(主要为环形、靶形和芽胞形3种),然后分析经过肾穿刺病理确诊的150例患者的特征变形红细胞的百分比,分成多个诊断值,分别计算敏感性和特异性,绘制受试者工作特征(ROC)曲线,并计算ROC曲线下面积(AUC)。结果 肾小球性血尿患者特征变形红细胞百分比>30%,而非肾小球性血尿患者特征变形红细胞百分比<10%。以特征变形红细胞百分比>30%为标准,诊断为肾小球性血尿,其敏感性为84%、特异性为97%、AUC为0.976,同时显著缩小了混合型血尿的范围。结论 以环形、靶形、芽孢形作为肾小球性血尿的特征变形红细胞,对诊断肾小球性血尿简单、易行,具有很好的实用价值。

关键词: 肾小球性血尿, 尿红细胞形态, 特征变形, 标准

Abstract:

Objective To seek a functional standard for the diagnosis of glomerular hematuria with little subjectivity. Methods Firstly,feature-deformed red blood cells(ring-,target- and spore- shaped red blood cells) were determined by light microscope,and its percentage in 150 diagnosed patients after renal biopsy was analyzed. Cut-off values were classified. The sensitivity and specificity were calculated,and receiver operating characteristic (ROC) curve was drawn. The area under ROC curve(AUC) was calculated. Results There were >30% feature-deformed red blood cells in patients with glomerular hematuria,while there were <10% feature-deformed red blood cells in patients without glomerular hematuria. Taking feature-deformed red blood cells >30% as standard for the diagnosis of glomerular hematuria,the sensitivity was 84%,the specificity was 97%,and the AUC was 0.976. Meanwhile,the opportunity of processing mixed hematuria decreased. Conclusions Ring-,target- and spore-shaped red blood cells are practical for the diagnosis of glomerular hematuria.

Key words: Glomerular hematuria, Urinary red blood cell morphology, Feature deformation, Standard

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