Korpela M, Mustonen J, Heikkinen A, Helin H, Pasternack A
Department of Clinical Medicine, University of Tampere, Finland.
J Rheumatol. 1995 Mar;22(3):427-31.
To evaluate the prevalence and causes of isolated microscopic hematuria in patients with rheumatoid arthritis (RA).
An unselected population of 1018 patients with RA (810 women, 208 men) were studied prospectively (n = 604) or retrospectively (n = 414), and the results were compared with an age and sex matched control population (n = 457; 352 women, 105 men). Hematuria was defined as a positive dipstick result in 2 urine samples, and was regarded as isolated when no concomitant proteinuria was found (urine protein excretion < or = 0.15 g/24 h). To investigate the urological causes of isolated hematuria, urine cytology, renal ultrasound, and urethrocystoscopy were undertaken. Renal biopsy was performed when no urological lesions were found.
There was no difference in the prevalence of isolated hematuria between patients with RA and controls (women 10 and 9%, men 5 and 6%, respectively; total 9% for both). Mild mesangial glomerulopathy was the most common renal biopsy finding in patients with RA with isolated hematuria, found in 13 of 15 adequate renal biopsy specimens. The cause of hematuria remained uncertain or unknown in 52% of the patients with RA and in 61% of controls.
The prevalence of isolated microscopic hematuria was not significantly more frequent in patients with RA than in age and sex matched controls. This result was independent of the definition or grade of hematuria. Mesangial glomerulopathy was the most common renal biopsy finding in patients with RA with isolated hematuria.
评估类风湿关节炎（RA）患者中单纯镜下血尿的患病率及病因。
对1018例未经挑选的RA患者（810例女性，208例男性）进行前瞻性（n = 604）或回顾性（n = 414）研究，并将结果与年龄和性别匹配的对照人群（n = 457；352例女性，105例男性）进行比较。血尿定义为2份尿液样本试纸检测结果呈阳性，当未发现蛋白尿（尿蛋白排泄≤0.15 g/24 h）时视为单纯性血尿。为探究单纯性血尿的泌尿系统病因，进行了尿细胞学检查、肾脏超声检查及尿道膀胱镜检查。若未发现泌尿系统病变，则进行肾活检。
RA患者和对照组中单纯性血尿的患病率无差异（女性分别为10%和9%，男性分别为5%和6%；总体均为9%）。轻度系膜增生性肾小球病是RA伴单纯性血尿患者肾活检最常见的发现，15份足够的肾活检标本中有13份发现该病变。52%的RA患者和61%的对照组患者血尿病因仍不确定或不明。
RA患者中单纯镜下血尿的患病率并不显著高于年龄和性别匹配的对照组。这一结果与血尿的定义或分级无关。系膜增生性肾小球病是RA伴单纯性血尿患者肾活检最常见的发现。
