Janssens P M, Kornaat N, Tieleman R, Monnens L A, Willems J L
Central Clinical Chemical Laboratory, Academic Hospital Nijmegen-St. Radboud, The Netherlands.
Clin Chem. 1992 Feb;38(2):216-22.
We have further explored the immunocytochemical staining method to discriminate renal and nonrenal hematuria, reported by Abrass and Laird (Am J Kidney Dis 1987;9: 44-50). After fixation on slides with acetone, erythrocytes in urine were stained with antiserum against human Tamm-Horsfall protein. Reactions were made visible by using either a fluorescent second antibody or a biotinylated second antibody, avidin, and biotinylated horseradish peroxidase, producing an insoluble reaction product. The staining methods were validated with material from clinically diagnosed cases of hematuria of renal or nonrenal origin. In material from kidney transplantation patients, in samples from the catheter that were presumed to contain renal erythrocytes, 84.7% and 80.1% of the erythrocytes stained by the immunofluorescence and immunoperoxidase methods, respectively, whereas in samples from the catheter that were supposed to contain nonrenal erythrocytes, 9.3% and 13.1% of the cells stained. In a group of nontransplantation patients with various causes of renal hematuria, 87.3% and 89.8% of the erythrocytes in urine stained with the immunofluorescence and immunoperoxidase methods, respectively, whereas in samples from patients with hematuria of known nonrenal origin, 12.9% and 12.4% of the cells stained. Staining of erythrocytes in renal and nonrenal hematuria was significantly different (P less than 0.001) and better discriminated between renal and nonrenal hematuria than did inspection of the morphology of erythrocytes in urine.
我们进一步探究了由阿布拉斯和莱尔德报道的用于鉴别肾性和非肾性血尿的免疫细胞化学染色方法（《美国肾脏病杂志》1987年；9: 44 - 50）。用丙酮将尿液中的红细胞固定在载玻片上后，用抗人Tamm - Horsfall蛋白的抗血清对其进行染色。通过使用荧光二抗或生物素化二抗、抗生物素蛋白和生物素化辣根过氧化物酶使反应显色，产生不溶性反应产物。该染色方法已通过临床诊断的肾性或非肾性血尿病例的材料进行了验证。在肾移植患者的材料中，在推测含有肾红细胞的导尿管样本中，分别有84.7%和80.1%的红细胞通过免疫荧光法和免疫过氧化物酶法染色，而在推测含有非肾红细胞的导尿管样本中，分别有9.3%和13.1%的细胞染色。在一组因各种原因导致肾性血尿的非移植患者中，尿液中分别有87.3%和89.8%的红细胞通过免疫荧光法和免疫过氧化物酶法染色，而在已知非肾性血尿患者的样本中，分别有12.9%和12.4%的细胞染色。肾性和非肾性血尿中红细胞的染色有显著差异（P小于0.001），并且比检查尿液中红细胞的形态能更好地区分肾性和非肾性血尿。
