Mehta K, Tirthani D, Ali U
Nephrology Division, Bai Jerbai Wadia Hospital for Children and Research Centre, Parel, Bombay.
Indian Pediatr. 1994 Sep;31(9):1039-45.
We studied the urinary RBC morphology in 87 consecutive cases of significant hematuria by 3 commonly used methods: (a) light microscopy of the unstained urinary sediment; (b) phase contrast microscopy of the unstained urinary sediment; and (c) Wright's staining of the urinary sediment, in order to compare the sensitivity of these methods in detecting dysmorphic RBCs and thus predicting the site of hematuria. The clinical data and the relevant investigations were made available after the morphology of RBCs in the urine was identified. Out of the 87 patients, 45 had a glomerular and 42 had a nonglomerular cause o hematuria. Phase contrast microscopy showed a sensitivity of 91.1%, Wright's stain of 82.2% and light microscopy of 66.7% in detecting a glomerular source of hematuria. Nonglomerular hematuria could be detected in 92.9% cases by each of the 3 methods. It is concluded that phase contrast microscopy is most sensitive for the detection of dysmorphic RBCs in the urine, Wright's stain nearly as sensitive whilst light microscopy of the unstained sediment is least sensitive. Urinary RBC morphology is a useful adjunct in the diagnosis of hematuria and saves the patients from unnecessary investigations.
我们采用3种常用方法对87例连续性重度血尿患者的尿红细胞形态进行了研究：（a）未染色尿沉渣的光学显微镜检查；（b）未染色尿沉渣的相差显微镜检查；（c）尿沉渣的瑞氏染色，以比较这些方法在检测异形红细胞从而预测血尿部位方面的敏感性。在确定尿中红细胞形态后提供临床资料及相关检查结果。87例患者中，45例血尿病因是肾小球性的，42例是非肾小球性的。相差显微镜检查在检测肾小球源性血尿方面的敏感性为91.1%，瑞氏染色为82.2%，光学显微镜检查为66.7%。3种方法对非肾小球性血尿的检出率均为92.9%。结论是相差显微镜检查对尿中异形红细胞的检测最敏感，瑞氏染色几乎与之同样敏感，而未染色沉渣的光学显微镜检查最不敏感。尿红细胞形态在血尿诊断中是一项有用的辅助检查，可使患者避免不必要的检查。
