腎絲球血尿中之紅血球形態(I)尿液中紅血球形態對兒童血尿的鑑別診斷之評估

Red Cell Morphology in Glomerular Hematuria (I) Evaluation of Urinary Red Cell Morphology for Differential Diagnosis of Hematuria in Children

陳遠浩(Yuan-Hao Chen) ； 陳炯暉(Chiung-Hui Chen) ； 師健民(Chian-Ming Shih) ； 陳正成(Cheng-Chen Chen) ； 朱夢麟(Mong-Ling Chu) ； 馬正平(Cheng-Ping Ma)

《Acta Paediatrica Sinica》 27卷5期 (1986/10) Pp. 433-439

摘要

本研究以38位因血尿而住院的病童爲研究對象，分別以相對比(phase-contrast)光學顯微鏡及掃描電子顯微鏡(scanning electron microscopy)對這些病童的新鮮尿液中之紅血球形態來分析，以做為血尿來源的評估。若以尿液中變形紅血球有大於80%以上做為腎絲球出血之標準，且以臨床症狀，組織，生化及放射線學等實驗室檢查做為佐證時，在本研究的結果中顯示；以尿液中紅血球形態做為血尿來源之診斷，其敏感性(sensitivity)約為93.3%，而其專一性(specificity)可達100%。因此，我們認為相對比光學顯微鏡對尿液中紅血球形態之檢查是可對兒童的腎絲球與非腎絲球出血做一正確區分之一簡單，經濟，且無任何傷害性的篩檢方法。

並列摘要

Fresh urine samples collected from 38 hospitalized hematuria children were examined by phase-contrast and scanning electron microscopy to determine the probable site of bleeding into the urinary tract. When criterion of 80% urinary red cell dysmorphism was assigned as diagnostic for glomerulonephritis, and the causes of hematuria agreed with the clinical, histologic, and laboratory diagnosis, the examination of urinary red cell morphology had a diagnostic sensitivity of 93.3% and specificity of 100% in the 38 hematuria children. It is suggested that phase-contrast microscopic examination of red cell morphology in the urine is a single, inexpensive and noninvasive screening test to permit an accurate distinction between glomerular and nonglomerular bleeding in pediatric patients.

並列關鍵字

hematuria ； RBC morphology ； dysmorphic RBC ； glomerular bleeding