Gamé Xavier, Soulié Michel, Fontanilles Anne-Marie, Benoit Jean-Michel, Corberand Joel-Xavier, Plante Pierre
Department of Urologic Surgery, Rangueil University Hospital, Toulouse, France.
Urology. 2003 Mar;61(3):507-11. doi: 10.1016/s0090-4295(02)02251-3.
To determine the ability, reliability, and accuracy of urinary red blood cell volume distribution curves obtained with the use of an autoanalyzer to identify the origin of isolated microscopic hematuria and compare the results with those obtained with phase-contrast microscopy (PCM).
A prospective evaluation was performed in 45 patients with glomerular or nonglomerular microhematuria detected by urinalysis, PCM, radiologic evaluation, endoscopy, and, sometimes, renal biopsy. Urine samples were analyzed in an electronic particle-size analyzer, and the tests were repeated to assess reliability. The kappa correlation coefficient was used to assess reliability and to compare the results with the final diagnosis and with those obtained with PCM.
Of the 28 patients who had a single definite cause of hematuria, 16 had glomerular bleeding and 12 nonglomerular bleeding. The origin of hematuria was correctly identified by the autoanalyzer in 60.7% of cases. A statistically significant correlation was found with the final diagnosis (kappa = 0.433, P = 0.048). The reliability was excellent (kappa = 0.917, P <0.0001). Of 16 patients with glomerulonephritis, 10 (62.5%) were correctly identified by PCM and 14 (87.5%) by the autoanalyzer. In 12 patients with nonglomerular bleeding, PCM was accurate in 7 (58%) and the autoanalyzer in 3 (25%). The results were statistically correlated with the findings of PCM (kappa = 0.327, P <0.00001).
The use of an autoanalyzer is easy, reproducible, and noninvasive. It provides reliable information to orient the diagnosis toward glomerular or nonglomerular bleeding. It is as accurate as PCM for screening for the source of hematuria.
确定使用自动分析仪获得的尿红细胞体积分布曲线识别孤立性镜下血尿来源的能力、可靠性和准确性，并将结果与相差显微镜检查（PCM）的结果进行比较。
对45例经尿液分析、PCM、放射学评估、内镜检查，有时还包括肾活检检测出肾小球或非肾小球性镜下血尿的患者进行前瞻性评估。在电子粒度分析仪中分析尿液样本，并重复测试以评估可靠性。kappa相关系数用于评估可靠性，并将结果与最终诊断以及PCM获得的结果进行比较。
在28例有单一明确血尿病因的患者中，16例为肾小球性出血，12例为非肾小球性出血。自动分析仪在60.7%的病例中正确识别了血尿来源。与最终诊断有统计学显著相关性（kappa = 0.433，P = 0.048）。可靠性极佳（kappa = 0.917，P <0.0001）。在16例肾小球肾炎患者中，PCM正确识别出10例（62.5%），自动分析仪正确识别出14例（87.5%）。在12例非肾小球性出血患者中，PCM准确识别出7例（58%），自动分析仪准确识别出3例（25%）。结果与PCM的结果有统计学相关性（kappa = 0.327，P <0.00001）。
使用自动分析仪简便、可重复且无创。它为将诊断导向肾小球或非肾小球性出血提供可靠信息。在筛查血尿来源方面，它与PCM一样准确。
