肾小球疾病患者尿红细胞形态学特点及其与病理学结果的关系

摘要

目的 研究肾小球疾病患者尿红细胞形态学特点与其与病理学结果的关系,为肾小球疾病的临床治疗提供依据.方法 选取2016年1月至2017年3月该院进行治疗的肾小球疾病患者血尿标本260例,比较红细胞的细胞形态分类,统计标本不同病理类型的例数,计算原发性肾小球疾病和继发性肾小球疾病芽孢红细胞出现率.分析芽孢红细胞出现机制,研究芽孢红细胞与肾脏病理改变的关系.统计肾小球疾病患者血尿类型与芽孢红细胞出现情况,分析芽孢红细胞与肾性血尿的关系.结果 原发性肾小球疾病芽孢红细胞出现率高于继发性肾小球疾病,差异有统计学意义(P＜0.05).系膜细胞增殖是芽孢红细胞产生的影响因素(OR=0.352,P＜0.05),其他变量结果均无相关性.系膜细胞增殖为免疫球蛋白A(IgA)肾病的病变特征.与M0比较,M1更容易出现芽孢红细胞百分率超过5％的情况,差异有统计学意义(P＜0.05).出现芽孢红细胞的标本中多呈肾性血尿,极少呈混合性血尿,非肾性血尿中没有出现芽孢红细胞.结论 与继发性肾小球疾病比较,原发性肾小球疾病更易出现芽孢红细胞;系膜细胞增殖是芽孢红细胞产生的关键因素,其增殖程度与芽孢红细胞百分率相关.%Objective To study the relationship between morphological characteristics of urinary red cells and pathological findings in patients with glomerular diseases,and to provide evidence for the clinical treatment of glomerular diseases.Methods Totally 260 patients with glomerular disease in the hospital from January 2016 to March 2017 were selected.The morphological classification of erythrocytes was compared,the number of different pathological types was counted,and the incidence of sporadic erythrocytes of primary glomerular diseases and secondary glomerular diseases were calculated.The mechanism of sporocysts was analyzed,and the relationship between sporocysts and pathological changes in kidney was studied.Hematuria type and distribution of sporocytic erythrocytes in patients with glomerular diseases were analyzed,and the relationship between sporadic erythrocytes and renal hematuria was analyzed.Results The incidence of primary spherocytosis of primary glomerular disease was higher than secondary glomerular disease,the difference was statistically significant (P＜0.05).Mesangial cell proliferation was a key factor in the production of sporocysts (OR=0.352,P＜0.05).No correlation was found between other variables.Mesangial cell proliferation was characterized by immunoglobulin A (IgA) nephropathy.Compared with the M0,M1 is more likely to sporocysts ≥5％ of the situation,the difference was statistically significant(P＜0.05).Spleen red blood cells appeared mostly in renal hematuria specimens,rarely mixed hematuria,non-renal hematuria did not appear sporeshaped red blood cells.Conclusion Compared with secondary glomerulopathy,primary glomerular disease is more likely to appear spores erythrocytes.Mesangial cell proliferation is a key factor in the generation of spores,and its proliferation degree is related to the percentage of spores red blood cells.