Györy A Z, Hadfield C, Lauer C S
Br Med J (Clin Res Ed). 1984 Mar 17;288(6420):819-22. doi: 10.1136/bmj.288.6420.819.
Fresh, first morning specimens of urine from 22 consecutive patients were examined by quantitative microscopy on the morning of renal biopsy; the renal biopsy samples were evaluated "blindly." Five patients showed no abnormality in the biopsy samples but eight had minimal, one mild, six moderate, and two severe histological changes. Comparison of the results of quantitative microscopy of urine with the presence or absence of histological evidence of disease showed that sensitivity was 88%, specificity 83%, accuracy 86%, positive predictive value 93%, and negative predictive value 71%. When combined with microscopy of a second urine specimen these values were 100%, 50%, 87%, 85%, and 100% respectively. There was a significant relation between number of casts and severity of the histological changes (p less than 0.01). Comparison of renal functional abnormalities with histological findings gave values of 64%, 100%, 73%, 100%, and 50% respectively. It is concluded that quantitative microscopy of the first morning specimen of urine is a sensitive test with high predictive value for the presence or absence of renal disease. If no casts are detected in two early morning specimens the likelihood of finding anything more than minimal changes in a biopsy sample is virtually zero.
在进行肾活检的当天早晨，对22例连续患者的新鲜晨尿进行了定量显微镜检查；肾活检样本进行了“盲法”评估。5例患者的活检样本未显示异常，但8例有轻微、1例有轻度、6例有中度和2例有重度组织学改变。将尿定量显微镜检查结果与疾病组织学证据的有无进行比较，结果显示敏感性为88%，特异性为83%，准确性为86%，阳性预测值为93%，阴性预测值为71%。当与第二份尿标本的显微镜检查结果相结合时，这些值分别为100%、50%、87%、85%和100%。管型数量与组织学改变的严重程度之间存在显著相关性（p<0.01）。肾功能异常与组织学结果的比较分别得出64%、100%、73%、100%和50%的值。结论是，晨尿的定量显微镜检查是一项对肾病有无具有高预测价值的敏感检测。如果在两份晨尿标本中均未检测到管型，那么在活检样本中发现超过轻微改变的可能性几乎为零。
