Pillsworth T J, Haver V M, Abrass C K, Delaney C J
Department of Laboratory Medicine, Veterans Administration Medical Center, University of Washington, Seattle 98195.
Clin Chem. 1987 Oct;33(10):1791-5.
Recent studies indicate that hematuria of renal parenchymal origin can be differentiated from hematuria of other origin by the presence of dysmorphic urinary erythrocytes (cells exhibiting irregular membranes or small surface blebs). We investigated the utility of this simple screening assay in a routine clinical laboratory. Dysmorphic erythrocytes in urine from 69 patients (18 with renal-parenchymal disease) were quantified on unstained slides by medical technologists using phase-contrast microscopes. Samples stored at 4 degrees C or 23 degrees C for up to 5 h had no significant changes in percentages of dysmorphic erythrocytes (PDE). PDE was also not modified by urea nitrogen concentration, osmolality, or pH over the physiological ranges of these variables. Receiver-operating characteristic (ROC) curves indicated an optimal sensitivity of 88% and specifity of 94% at a decision level of 14% dysmorphic erythrocytes per high-power field. Thus, the presence of fewer than 14% dysmorphic cells is suggestive of extra-renal disease; more than 14% is suggestive of intra-renal disease.
近期研究表明，肾实质源性血尿可通过畸形尿红细胞（细胞膜不规则或表面有小泡的细胞）的存在与其他来源的血尿相鉴别。我们在常规临床实验室研究了这种简单筛查试验的实用性。医学技术人员使用相差显微镜对69例患者（18例患有肾实质疾病）尿液中的畸形红细胞进行了定量分析，样本在4℃或23℃下保存长达5小时，畸形红细胞百分比（PDE）无显著变化。在这些变量的生理范围内，尿素氮浓度、渗透压或pH值也不会改变PDE。受试者工作特征（ROC）曲线表明，在每高倍视野畸形红细胞占14%的判定水平下，最佳灵敏度为88%，特异性为94%。因此，畸形细胞少于14%提示肾外疾病；超过14%提示肾内疾病。
