Abstract: AbstractObjectiveThis study aims at evaluating the effect and the possible role of light microscopy and urine flow cytometer in detecting the source of hematuria in children,for a better understanding of various histopathology of isolated hematuria. Methods (1) The children who had been diagnosed as having glomerular diseases underwent renal biopsy.(2) The morning urine specimen from the group of glomerular diseases as well as the group of nonglomerular diseases were collected for the red blood cell morphological examination by light microscopy.In addition,the samples from some of the patients with glomerular diseases and some of the patients with nonglomerular diseases were examined by using UF50 urine flow cytometer. Results(1) The group of 125 children with clinical diagnosis of glomerular diseases were confirmed by pathological examination.(2) The diagnostic criteria for glomerular hematuria were those with severe dysmorphic RBC≥30% or dysmorphic RBC≥70%.Both specificity reached over 90%,but the sensitivity of the UF50 automated urine analyzer was lower.(3) The positive rate of glomerular hematuria by ordinary light microscopy and urine flow cytometer in testing the same day’s morning urine and random urine samples had no significant differences. Conclusion(1) This series of data indicate that if we use the diagnostic criteria for glomerular hematuria with dysmorphic RBC≥70% or severe dysmorphic RBC≥30%,the sensitivity and specificity are both higher.(2) Both specificity of the two methods reachs over 90%,but the sensitivity of the UF 50 automated urine flow cytometer is lower.(3)The random urine specimen could be accepted with the two methods in children.

Key words: Light microscopy, Sysmex UF 50 automated urine flow cytometer , Renal biopsy, Red cell morphology

摘要： 目的探讨应用普通光学显微镜检查尿红细胞形态和UF50尿液全自动分析仪2种方法对儿童血尿定位诊断的作用和影响因素。 方法研究对象为197701—200601首都儿科研究所肾内科病房收治的临床出现血尿患儿125例，均经肾活检证实为肾小球源性疾病。应用普通光学显微镜对经肾脏病理证实为肾小球疾病和非肾小球疾病患者的晨尿进行红细胞形态的检查；同时应用UF50尿液全自动分析仪对其中部分肾小球和非肾小球疾病患者的同一标本进行尿红细胞参数测定。 结果(1)肾小球疾病组患者均经病理检查所证实。(2)以RBC严重变形≥30%或变形≥70%两者之一作为肾性血尿的诊断标准,其特异度均达到90%以上，但全自动尿液分析仪的灵敏度较低。(3)晨尿和随意尿标本经上述2种方法检查，其肾性血尿阳性率差异无显著性。 结论资料显示以RBC变形≥70%或严重变形≥30%作为诊断肾性血尿的标准，其灵敏度和特异度较高；光镜检测尿红细胞形态与UF50全自动尿液分析仪用于肾小球性血尿检测，其特异度均达到90%以上，但UF50全自动尿液分析仪的灵敏度较低；儿童可选用随意尿作为2种方法的检测标本。

关键词: 血尿, 肾组织活检, 红细胞形态, 光学显微镜, UF50全自动尿液分析仪