Objective To investigate the clinical significance of immunofluorescence staining of urine erythrocytes for Tamm-Horsfall protein (THP) in determining the origin of hematuria, and to sum up the hematuria situation from 2004 to 2007 for understanding pathological distribution between renal hematuria and non-renal hematuria. Methods Urine erythrocytes from 30 patients of glomerular hematuria and 25 patients of non-glomerular specimens were immunocytochemically stained with antibody against human Tamm-Horsfall protein. The results were compared with the pathological findings. Results Among the 30 patients of glomerular hematuria according to pathological diagnosis, 28 were confirmed by the immunofluorescence assay, with a coincidence rate of 93.3%. Among the 25 patients of non-renal hematuria according to pathological diagnosis, 22 were confirmed by the immunofluorescence assay, with a coincidence rate of 88%. Pathologic analysis showed IgA nephropathy in 16 of the patients with renal he-maturia (16/30, 53.3%), small glomerular lesions in 10 patients (10/30, 33.3%), non-IgA nephropathy mesangial cell proliferative glomerulonephritis in 3 patients (3/30, 10.0%) and focal sclerosing lomerulonephritis stage in 1 patients (1/30, 3.3%). Conclusion Immunofluorescence staining of urine erythrocytes for THP are stable, accurate, objective and reliable for identifying the origin of hematuria, which provides the foundation of the early diagnosis and treatment of patients with hematuria.%目的 探讨尿红细胞T-H蛋白(Tamm-Horsfall protein,THP)免疫荧光检测在鉴定尿红细胞来源中的临床应用价值,并对2004-2007年临床诊断单纯血尿情况进行总结,了解肾性血尿与非肾性血尿的病因和分布特点.方法 利用尿红细胞THP免疫荧光染色技术对明确诊断的30例肾小球性血尿和25例非肾小球性血尿标本进行尿红细胞的THP免疫荧光染色,并与病理结果进行比较分析.结果 在病理诊断确定的30例肾小球性血尿中,THP检测诊断肾性血尿28例,符合率为93.3％；在临床明确诊断的非肾性血尿25例中,THP检测确定非肾性血尿22例,符合率为88％.病理分析显示肾性血尿中,IgA肾病16例(533％),肾小球微小病变10例(33.3％),非IgA肾病的系膜细胞增殖性肾小球肾炎3例(l0.0％),局灶阶段性硬化性肾炎l例(3.3％).结论 THP免疫荧光染色鉴别尿红细胞来源的方法特异性强,是鉴别肾性与非肾性血尿的一种有价值的诊断方法,能够为血尿患者的早期诊断与治疗提供临床依据.
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