采用基于红细胞形态学参数的Fisher判别法鉴别血尿来源
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摘要
目的探讨红细胞形态学参数对血尿来源的鉴别价值。方法选取2016年7月至2017年3月该院肾病风湿内科和肾病风湿科门诊拟诊为肾脏疾病的患者102例,根据病理"金标准"将疑似患者确诊,并分为肾源性血尿33例(肾病组)和非肾源性血尿69例(非肾病组)。所有研究对象均检测尿液红细胞畸形率、尿液红细胞数量、尿液红细胞平均体积(u-MCV)和尿液红细胞体积分布宽度(u-RDW)。从中选取有统计学差异的指标,建立相应的Fisher判别模型。结果肾病组与非肾病组的尿液红细胞畸形率、u-MCV和u-RDW比较,差异有统计学意义(P<0.05)。建立了Fisher判别模型,通过回代性检验得到该组模型鉴别诊断的灵敏度为88.3%,特异度为83.8%,准确率为86.4%。结论联合多个尿液红细胞形态学参数建立Fisher判别模型能提高鉴别肾源性血尿和非肾源性血尿的准确率,具有一定的实用价值。
Objective To investigate the differential diagnostic value of erythrocyte morphological parameters for hematuria.Methods Totally 102 patients with suspected kidney diseases from July 2016 to March2017 in the hospital were selected and divided into two groups,33 cases of nephrogenic hematuria(nephropathy group)and 69 cases of non-nephrogenic hematuria(non-nephropathy group).The rate of urinary erythrocyte deformity,the number of urinary erythrocytes,the mean volume of urinary erythrocytes(u-MCV)and the distribution width of urinary erythrocyte volume(u-RDW)were measured in all subjects.The indexes of statistical difference were selected,and the corresponding Fisher discriminant model was established.ResultsThe differences of urine erythrocyte deformity rate,u-MCV and u-RDW between nephrotic group and non-nephrotic group were statistically significant(P<0.05).Fisher discriminant model was established.The regression test showed that the sensitivity,specificity and accuracy of the model were 88.3%,83.8%and 86.4%,respectively.Conclusion Establishing Fisher discriminant model combined with several morphological parameters of urine erythrocyte can improve the accuracy of distinguishing renal hematuria from non-renal hematuria,and has certain practical value.
Objective To investigate the differential diagnostic value of erythrocyte morphological parameters for hematuria.Methods Totally 102 patients with suspected kidney diseases from July 2016 to March2017 in the hospital were selected and divided into two groups,33 cases of nephrogenic hematuria(nephropathy group)and 69 cases of non-nephrogenic hematuria(non-nephropathy group).The rate of urinary erythrocyte deformity,the number of urinary erythrocytes,the mean volume of urinary erythrocytes(u-MCV)and the distribution width of urinary erythrocyte volume(u-RDW)were measured in all subjects.The indexes of statistical difference were selected,and the corresponding Fisher discriminant model was established.ResultsThe differences of urine erythrocyte deformity rate,u-MCV and u-RDW between nephrotic group and non-nephrotic group were statistically significant(P<0.05).Fisher discriminant model was established.The regression test showed that the sensitivity,specificity and accuracy of the model were 88.3%,83.8%and 86.4%,respectively.Conclusion Establishing Fisher discriminant model combined with several morphological parameters of urine erythrocyte can improve the accuracy of distinguishing renal hematuria from non-renal hematuria,and has certain practical value.
引文
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[10]汪伟,王艳,方华.尿液红细胞形态筛查在肾脏疾病诊断中的应用[J].检验医学与临床,2016,13(5):617-618.
[11]李玉花.尿红细胞形态及平均体积在在血尿定位应用分析[J].实验与检验医学,2016,34(4):448-450.
[12]刘树军,刘声茂,崔英春,等.肾小球源性血尿患者的临床病理研究[J].中国实验诊断学,2012,16(6):1125-1126.
[13]张莉.尿红细胞平均体积及红细胞形态检查在血尿定位中的应用[J].当代医学,2013,19(23):20-21.
[14]平牧野,丛玉隆.尿红细胞形态及其相关参数的研究进展[J].检验医学与临床,2016,13(5):700-703.
[15]胡志愿,郭璐娣,苏丹,等.尿红细胞形态、容积曲线及血红细胞容积曲线鉴别血尿来源[J].实验与检验医学,2013,31(2):125-127.
[2]SULTANA T,SULTANA T,RAHMAN M Q,et al.Value of dysmorphic red cells and G1cells by phase contrast microscopy in the diagnosis of glomerular diseases[J].Mymensingh Med J,2011,20(1):71-77.
[3]赵萍.普通光学显微镜独特形态红细胞鉴别血尿临床意义[J].检验医学与临床,2011,8(4):506-507.
[4]程正东,章毓晋,樊祥,等.常用Fisher判别函数的判别矩阵研究[J].自动化学报,2010,36(10):1361-1370.
[5]王平平,马文,张善辉,等.普通光镜检查尿红细胞形态在血尿来源诊断中的价值[J].国际检验医学杂志,2012,33(23):2909-2911.
[6]李小龙,陈晓东,舒旷怡.尿中红细胞形态镜检和MCV测定及临床意义[J].临床检验杂志,2004,22(1):39-40.
[7]刘金祥,丁勇,曹翠云,等.尿红细胞形态判断标准探究[J].检验医学,2017,32(7):582-585.
[8]刘媛,但刚,江忠勇,等.相差镜检联合UF-1000iRBC参数对肾小球性血尿的诊断价值[J].四川医学,2015,36(8):1153-1156.
[9]黄家勤,谭同均,何玉琼,等.Sysme UF-1000i尿沉渣分析仪检测尿红细胞形态参数结果的评价[J].吉林医学,2013,34(20):4033-4034.
[10]汪伟,王艳,方华.尿液红细胞形态筛查在肾脏疾病诊断中的应用[J].检验医学与临床,2016,13(5):617-618.
[11]李玉花.尿红细胞形态及平均体积在在血尿定位应用分析[J].实验与检验医学,2016,34(4):448-450.
[12]刘树军,刘声茂,崔英春,等.肾小球源性血尿患者的临床病理研究[J].中国实验诊断学,2012,16(6):1125-1126.
[13]张莉.尿红细胞平均体积及红细胞形态检查在血尿定位中的应用[J].当代医学,2013,19(23):20-21.
[14]平牧野,丛玉隆.尿红细胞形态及其相关参数的研究进展[J].检验医学与临床,2016,13(5):700-703.
[15]胡志愿,郭璐娣,苏丹,等.尿红细胞形态、容积曲线及血红细胞容积曲线鉴别血尿来源[J].实验与检验医学,2013,31(2):125-127.