Shichiri M, Hosoda K, Nishio Y, Ogura M, Suenaga M, Saito H, Tomura S, Shiigai T
Kidney Centre, Tokyo Metropolitan Ookubo Hospital, Japan.
Lancet. 1988 Apr 23;1(8591):908-11. doi: 10.1016/s0140-6736(88)91715-1.
The distribution curves of urinary red-blood-cell (RBC) size were obtained from automated blood-cell analysis in 146 patients with definite causes of haematuria. In 65 of 67 patients (97%) with haematuria and glomerulonephritis demonstrated by renal biopsy, urinary RBC had an irregular and asymmetrical distribution with RBC size showing a much smaller volume than that of venous RBC. This "glomerular" distribution contrasted with the "non-glomerular" normal distribution when the peak for RBC was at a larger volume than that for peripheral RBC. In 46 of 47 patients with haematuria who had lower urinary tract lesions other than infection, a non-glomerular distribution was obtained; 30 of these cases also showed glomerular distribution, and were classified as "mixed". All 32 patients with urinary tract infection had either a glomerular or mixed distribution, suggesting that they excreted distorted and dysmorphic urinary RBC. After excluding infections, this simple, rapid, reproducible, and non-invasive technique provides reliable information in distinguishing glomerular bleeding from other causes of haematuria.
通过自动血细胞分析，获取了146例血尿病因明确患者的尿红细胞（RBC）大小分布曲线。在经肾活检证实为血尿合并肾小球肾炎的67例患者中，有65例（97%）尿RBC呈不规则和不对称分布，RBC大小显示出比静脉血RBC小得多的体积。当RBC峰值体积大于外周血RBC时，这种“肾小球性”分布与“非肾小球性”正常分布形成对比。在47例血尿患者中，除感染外有下尿路病变的46例获得了非肾小球性分布；其中30例也显示出肾小球性分布，被归类为“混合性”。所有32例尿路感染患者均有肾小球性或混合性分布，提示他们排出的是变形和异形尿RBC。排除感染后，这项简单、快速、可重复且无创的技术在区分肾小球性出血与其他血尿病因方面提供了可靠信息。
