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요중 적혈구의 현미경적 손견에 의한 사구체 혈뇨와 비사구체 혈뇨의 감별 |
강응택 , 유석희 , 차영주 |
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Abstract |
Differentiation of the glomerular bleeding from the nonglomerular bleeding is important in diagnosis, treat- ment and prospection of prognosis of underlying dis- eases. However, proteinuria and pathologic casts which are considered to be glomerular origin show wide range of variation in according to disease per se or during the course of disease. We examined urine samples microsocpically from 96 patients of hematuria who had been diagnosed by renal biopsies or other radioloic examinations to determine the probable sites of bleeding into urinary tract. The results were as follows: 1) Dysmorphic erythrocytes were present in 76% of patients with glomerulopathies, isomorphic erythrocytes in 15.2% and mixed forms in 8.8%. 2) Among 40 patients with nonglomerular bleeding, isomorphi feature of urinary erythrocytes were present in 38 cases. 3) In 10 patients with acute renal failure, there is no constant finding in urinary erythrocyte morphology. 4) Among patients with glomerulopathies, significant proteinuria were noticed in 63% of patients and path- ologic casts in 35% of patients. 5) The sensitivity of differetiation of glomerular and nonglomerular bleeding by light microscopic examina- tion of urinary RBC morphology was 84.8% and the specificty was 95%. Therefore, light microscopic examination of urinary RBC morphology was convenient and useful preliminary method in differentiation of glomerular hematuria from nonglomerular hematuria in despitae of acurate diagno- sis of underlying disease. |
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