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目的通过对肾出血性疾病患者尿液检测分析,探讨尿流式细胞检测技术对肾出血性疾病的诊断价值。方法用尿流式细胞检测技术、显微镜法对肾出血患者、肾炎患者、健康人尿液同时进行检测分析。尿流式细胞技术对尿中有形成分直接进行荧光染色,在鞘流液的作用下,形式单列,快速通过散射光强度(RBC-MFsc)、红细胞平均前向散射光分布宽度(RBC-Fsc-DW)、红细胞前向散射光强度(RBC-P70 Fsc)等红细胞提示信息及红细胞前向散射光强度直方图等指标,进行了综合分析和计算得到相应细胞的长度、大小、体积和染色质长度的资料,并作出红细胞、管型等有形成分的散点图和定量报告。尿流式细胞仪、显微镜法检测均在尿液收集后2 h内测试完成。结果 40例肾炎疾病的尿液标本中,UF-1000i尿沉渣检测仪红细胞提示,非均一性红细胞37例,混合性红细胞1例,均一性细胞2例,准确率93%;普通显微镜检查,异形红细胞33例,正常红细胞7例,准确率83%。130例肾出血性疾病尿标本中,尿流式细胞仪提供的均一性红细胞为119例,准确率92%;显微镜检查正常红细胞118例,特异性为91%。UF-1000i尿沉渣检测仪与普通显微镜检查结果对肾病血尿敏感性及特异性均无显著差异(P>0.05)。结论通过对尿液中红细胞形态及数量的检测,可对肾炎与肾出血性疾病进行确认性鉴别诊断;应用尿流式细胞分析仪对尿中红细胞的多参数进行综合分析,并结合管型检测结果的辅助诊断,对肾炎、肾出血性疾病的鉴别诊断的准确率达到90%以上。
Objective To analyze the urinalysis of patients with renal hemorrhagic disease and to explore the diagnostic value of uroflow cytometry in the diagnosis of renal hemorrhagic disease. Methods Urine flow cytometry and microscopy were used to detect and analyze the urine of patients with renal hemorrhage, nephritis and healthy people at the same time. Urine flow cytometry was used to directly stain the visible components in the urine. Under the action of the sheath fluid, the form of RBC-Fsc (RBC-Fsc) was rapidly determined by the scattered light intensity (RBC-MFsc) -DW), red blood cell RBC-P70 Fsc (RBC-P70 Fsc), and histogram of RBC scattered light intensity were analyzed and calculated. The length, size, volume and chromatin Length of the data, and make red blood cells, tubes and other physical components of the scatter plot and quantitative reports. Urine flow cytometry, microscopic examination were completed within 2 h after the urine collection test. Results In urine samples of 40 cases of nephritis disease, UF-1000i urinary sediment analyzer showed that 37 cases of heterogeneous erythrocytes, 1 case of mixed erythrocytes and 2 cases of homogenous cells, the accuracy rate was 93%. The results of routine microscopy, 33 cases of red blood cells, 7 cases of normal red blood cells, the accuracy rate of 83%. In 130 urine samples of renal hemorrhagic disease, 119 cases of homogeneous erythrocytes were provided by uroflow cytometry, with an accuracy rate of 92%. There were 118 cases with normal erythrocytes microscopically and the specificity was 91%. UF-1000i urinary sediment detector and conventional microscopic examination of renal disease hematuria sensitivity and specificity were not significantly different (P> 0.05). Conclusion The detection of neutrophil and renal hemorrhagic disease can be confirmed by the detection of the morphology and quantity of red blood cells in urine. The multi-parameters of urinary erythrocytes were analyzed by uroflow cytometer and combined with tube-type test The results of the auxiliary diagnosis of nephritis, renal bleeding disease differential diagnosis accuracy rate of 90% or more.