Fünfstück R, Stein G
Funktionsbereich Nephrologie, Klinik für Innere Medizin IV, Universität Jena.
MMW Fortschr Med. 2000 Mar 2;142(9):30-2.
On the basis of an evaluation of the morphology of erythrocytes in urinary sediment, it is possible to distinguish between nephrological and urological hematuria. In the case of the former, the cells have "disruptive characteristics" (membrane evagination, ring formations, dwarf forms and loss of hemoglobin), enabling them to be distinguished from the regularly formed erythrocytes from hemorrhage within the urinary tract. Dysmorphic erythrocytes retain their characteristic shapes even when persisting in the urine for lengthy periods. An assessment of erythrocyte morphology forms a suitable basis for choosing appropriate further diagnostic measures for urological or nephrological work-up. The method of examination is simple and readily reproducible, and should therefore form an early part of the diagnostic strategy. Microscopic assessment erythrocyte shape is not suitable for the diagnostic work-up of tumors, nor can it obviate the need for kidney biopsy for the investigation of histomorphological changes in glomerular nephritis.
基于对尿沉渣中红细胞形态的评估，有可能区分肾性血尿和泌尿外科血尿。对于前者，细胞具有“破坏特征”（膜外翻、环形、矮小形态和血红蛋白丢失），使其能够与尿路内出血产生的形态规则的红细胞区分开来。畸形红细胞即使在尿液中长时间存在也能保持其特征形状。红细胞形态评估为泌尿外科或肾脏科进一步检查选择合适的诊断措施提供了合适的依据。检查方法简单且易于重复，因此应成为诊断策略的早期部分。显微镜下评估红细胞形态不适用于肿瘤的诊断检查，也不能排除对肾小球肾炎组织形态学变化进行肾脏活检的必要性。
