【摘要】 目的　探讨尿沉渣定量分析方法及其影响因素。方法　选择经肾活检确诊的肾脏病患者以及肾移植患者共 10例 ,比较显微镜尿沉渣镜检染色定量计数板和尿沉渣自动定量测定仪 (UF 10 0 )对同一样本中管型和上皮细胞的检测结果 ;细胞染色采用改良巴氏染色 ;尿液细胞碎片采用流式碘化丙啶 (PI)染色检测。结果　流式细胞仪检测尿沉渣中的管型和上皮细胞较显微镜镜检结果分别增高 8.83倍和 5 .83倍 (P <0 .0 5 )。对患者同一尿沉渣分别用HDF液、正常人尿液和患者尿液进行悬浮并置 4℃保存 ,随着留置时间的延长 ,其上皮细胞数均逐渐减少 (P <0 .0 5 ) ,同时均伴有细胞碎片率逐渐增加。在 8h和 16h ,用患者尿液处置的尿沉渣细胞碎片率均明显高于HDF组 (P <0 .0 5 )。在 8h时 ,用正常人尿液处置的尿沉渣细胞碎片率明显低于患者尿液处置组(P <0 .0 5 )。而各组患者尿沉渣管型计数的差异无显著性 (P >0 .0 5 )。患者尿沉渣 (3例 )分别用HDF、丙酮、乙醇和多聚甲醛固定、置 - 2 0℃保存 1周后进行PI染色 ,其细胞碎片率分别为 (31.6± 6 .4 ) %、(6 6 .4± 2 .7) %、(4 9.6± 1.4 5 ) %和 (6 5 .9± 3.4 ) % ,HDF和乙醇组细胞碎片率低于丙酮和多聚甲醛组 (P <0 .0 5 )。结论　应用荧光流式细胞仪和显微镜镜检定量计数对?更多还原

【Abstract】 Objective To establish a method of quantitative analysis of urinary sediments. Methods 10 patients with renal diseases or renal transplantation were selected. All the patients’ diagnosis was confirmed by biopsy. Casts and epithelial cells from the same sample were analyzed by both microscopic quantitation and auto analysis of urinary sediments (UF-100). Urinary sediments were also quantitated through using modified Papanicolaou staining in microscopic quantitation and propidium iodide staining in flow cytometric analysis. Results In comparison with microscopic quantitation, flow cytometric analysis yielded 8.83 and 5.83 folds higher detection rate of urinary casts and epithelial cells, respectively (P <0.05). The same urinary sediments were placed at 4℃ in HDF buffer, volunteers or patients’ urine, respectively. We found that the number of epithelial cells gradually decreased (P <0.05) with a concurrent increase of debris. At 8 h and 16 h, the debris rate was significantly higher in the sediments with treated patient’s urine than those treated with HDF (P <0.05). At 8 h, debris rate was significantly lower in sediments with treated volunteers’urine than those with patient’s urine (P <0.05). However, no significant difference was observed in terms of casts quantitation between these groups (P >0.05). Urinary sediments from patients were also preserved at -20℃ in HDF, acetone, ethanol and paraformaldehyde, and underwent PI staining after one week. Flow cytometric analysis showed debris rates of ( 31.6 ±6.4)%, ( 66.4 ±2.7)%, ( 49.6 ±1.45)% and ( 65.9 ±3.4)%, respectively. HDF and ethanol groups had significantly lower rates of debris than acetone and paraformaldehyde groups (P <0.05). Conclusion Flow cytometric analysis and microscopic quantitation of urinary casts and epithelial cells yield significant difference. Microscopic detection and quantitation of urinary casts and cytology remain a reliable diagnostic method. Urine from patients may contain more cell injury-induced factors. Urinary samples should be processed differently to meet the requirement of special purposes.更多还原