요 적혈구 용적변화에 의한 소아혈뇨의 감별진다

Abstract

Hematuria is a important clinical sign that is a consequence of significatn renal, urologic or sytemic disease. Recently the morphology of the red cell in hematuria has been used to indicate a renal or non-renal source and also the measurement of red cell volume by red cell analyzer has been used to distinguish glomerular from non-glomerular hematuria. In this study, the MCV(mean corpsular red cell voume), RDW(red cell distributio width) and HDW(hemoglobin distribution width) were measured using H-1 system in 57 children with hematuria to assess the diagnostic usefulness of the urinary red cell analyzer in the differentation of glomerular and non-glomerular hematuria. The patient were divided into two groups as glomerular disease (40 cases) and non- glomerular disease (17 cases) and the location of the bleeding was confirmed by renal biopsy, radiology and the clinical findings. The results were as follows. 1) The urinary red cell MCV was lower in patients with glomerular disease than that in patients with non- glomerular disease (79.89¡¾12.0fL vs. 90.93¡¾9.71fL vs. 90.93¡¾9.71fL; p<0.01) 2) The urinary RDW and HDW were significantly highter in glomerular diseases that those in non-glomerular diseases (RDW; 19.86¡¾11.28% vs 11.34¡¾5.88%, HDW; 3.37¡¾2.07gm vs. 1.86¡¾1.43gm). 3) The urinary red cell MCV was correlated well with the RDW and HDW while there was no correlation between the urinary red cell MCV and the urinary SG or Ph. 4) The sensitivity, specificity and positive predictability of the urinsary MCV were 37.8%, 94.1% and 93.7% and those of RDW were 62.5%, 82.3% an 89.2%. 5) The sensitivity, specificity and positive predictability of the urinary HDW were 42.5%, 88.2% and 89.4%. We concluded from above data that the measurement of the urinary MCV, RDW and HDW would be useful as a primary non-invasive screening test in differentation of glomerular and non-glomerular hematuria in children.