摘要
综述该研究所１９８４～１９９４年对血尿进行定位诊断的系列研究：①在国内首次报告用位相显微镜检查尿红细胞形态及尿红细胞活体染色后光镜检查对诊断血尿来源的价值，认为当尿中红细胞以畸形为主（＞７５％），且畸形红细胞计数＞８×１０６／Ｌ，揭示为肾小球性血尿；②在国内首次提出了一种新的尿红细胞分类计算法以鉴别血尿来源；③在国内率先提出利用血细胞自动分析仪测定尿红细胞体积可判别血尿来源，发现若尿红细胞体积分布曲线呈肾小球性分布，尿平均红细胞体积小于正常红细胞体积，应考虑肾小球性血尿；④通过体内和体外模拟实验，在国内首次证实，尿红细胞形态学和尿红细胞体积变化的机制是肾小球滤过膜的机械损伤和尿ｐＨ、渗透压等化学因素共同作用的结果；⑤根据进一步的研究结果，在国内率先指出，畸形红细胞尿可能也见于小管－间质性疾病；⑥在尿蛋白测定对血尿定位诊断的价值的研究方面填补了国内空白。
The significance of urinary dysmorphic erythrocytes and determination of proteinuria in the diagnosis of glomerular hematuria , and mechanism of urinary erythrocyte deformity were studied. The results showed that glomerular hematuria was indicated if dysmorphic erythro- cyto was predominant (>75%) and dysmorphic erythrocyte count >8 ×106/L in urine , or if urinary erythrocyte corpuscular volume distribution curve was glomerular and mean corpus- cular volume less than that of normocyte. And a more objective , accurate morphological classification of urinary erythrocytes was developed for differentiating glomerular from non- glomerular hematuria. Our data suggest that mechanism of glomerular-originated hematuri- na may result from the passage of the cell through narrow defects in the raptured glomerular capillary wall and from a chemical injury to the cell in tubular lumen induced by urinary con- stituents. Further studies disclosed that urinary dysmorphic erythocyte might not only be the characteristic of glomerular but also of tubulo-interstitial diseases. Our studies also conclud- ed that glomerular hematuria was suggested if urinary protein excretion >0. 4 g/L in patient with gross hematuria , or >0. 2 g/L in microscopic hematuria.
出处
《中山医科大学学报》
CSCD
1996年第2期81-85,共5页
Academic Journal of Sun Yat-sen University of Medical Sciences
基金
国家自然科学基金
关键词
血尿
蛋白尿
红细胞
异常
鉴别诊断
hematura/diagnosis : proteinuria
erythrocytes , abnormal
diagno- sis, differential
