[1]叶玉华,陈雅斌,汪文煌,等.尿有形成分多指标联合构建诊断肾小球源性血尿的列线图研究[J].现代检验医学杂志,2026,41(02):58-62.[doi:10.3969/j.issn.1671-7414.2026.02.010]
　YE Yuhua,CHEN Yabin,WANG Wenhuang,et al.Study on the Diagnosis of Glomerular Hematuria Using a Nomogram Constructed by Combining Multiple Indicators of Urine Formed Elements[J].Journal of Modern Laboratory Medicine,2026,41(02):58-62.[doi:10.3969/j.issn.1671-7414.2026.02.010]
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尿有形成分多指标联合构建诊断肾小球源性血尿的列线图研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第41卷
期数:
2026年02期
页码:
58-62
栏目:
论著
出版日期:
2026-03-15

文章信息/Info

Title:
Study on the Diagnosis of Glomerular Hematuria Using a Nomogram Constructed by Combining Multiple Indicators of Urine Formed Elements
文章编号:
1671-7414（2026）02-058-05
作者:
叶玉华1，陈雅斌1，汪文煌1，王婉妮1，周静琪2
1.福建医科大学附属泉州第一医院检验科，福建泉州 362000;2.泉州市传染病防治院检验科，福建泉州 362000
Author(s):
YE Yuhua1，CHEN Yabin1，WANG Wenhuang1，WANG Wanni1，ZHOU Jingqi2
1.Department of Clinical Laborato-ry, Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian Quanzhou 362000, China;2.Department of Clinical Laboratory, Quanzhou Infectious Disease Hospital of Fujian Province, Fujian Quanzhou 362000, China
关键词:
尿有形成分; 肾小球源性血尿; 列线图
分类号:
R446.12
DOI:
10.3969/j.issn.1671-7414.2026.02.010
文献标志码:
A
摘要:
目的?研究尿有形成分指标与肾小球源性血尿的相关性,并构建预测肾小球源性血尿的列线图。方法选取2023年9月~2024年3月泉州市第一医院检验科检测的血尿标本235例的结果进行回顾性分析。根据临床是否诊断为肾小球肾炎(GN)将血尿标本分为肾小球源性血尿组和非肾小球源性血尿组。比较两组尿有形成分指标的水平差异,包括透明管型(Hy.CAST)、病理管型(Path.CAST)、肾小管上皮细胞(RTEC)、红细胞形态信息(RBC-INFO)、大红细胞百分比(largeRBC%)、小红细胞百分比(smallRBC%)、未溶解红细胞百分比(NLRBC%)和溶解红细胞百分比(LyRBC%)等。Logistic二元回归分析明确肾小球源性血尿的危险因素,并进一步构建列线图。受试者操作特征(ROC)曲线评估列线图中单项指标及构建的列线图筛查肾小球源性血尿的诊断效能。结果肾小球源性血尿组Hy.CAST、smallRBC%、LyRBC%水平明显升高(Z=-2.993、-11.817、-7.705),而largeRBC%、NLRBC%水平明显降低(Z=-11.724、-7.505),差异具有统计学意义(均P<0.001)。RBC-INFO的分类中肾小球源性血尿组以“混合性血尿”为主,而非肾小球源性血尿组以“均一性血尿”为主,差异具有统计学意义(χ2=116.963,P<0.001)。单危险因素分析显示RBC-INFO分类以“混合性血尿”为主,Hy.CAST、smallRBC%、LyRBC%水平升高,largeRBC%、NLRBC%水平降低是肾小球源性血尿发生的危险因素。受试者操作特征(ROC)曲线分析显示RBC-INFO、Hy.CAST、smallRBC%、LyRBC%以及构建的列线图均可有效筛查肾小球源性血尿,其中列线图曲线下面积(AUC)最高。结论联合尿有形成分多项指标(RBC-INFO、Hy.CAST、smallRBC%、LyRBC%)构建的列线图可用于预测肾小球源性血尿,为临床判断血尿来源提供有效参考。
Abstract:
Objective To study the correlation between urine formed elements indicators and glomerular hematuria, and to con-struct a nomogram for predicting glomerular hematuria. Methods A retrospective analysis was conducted on 235 hematuria specimens tested by the Clinical Laboratory of Quanzhou First Hospital from September 2023 to March 2024. According to clini-cal diagnosis of glomerulonephritis (GN), hematuria specimens were divided into two groups: glomerular hematuria and non-glo-merular hematuria. Differences in urinary formed element indices were compared between two groups, including hyaline cast (Hy.CAST), pathological cast (Path.CAST), renal tubular epithelial cells (RTEC), red blood cell information (RBC-INFO), large red blood cell percentage (large RBC%), small red blood cell percentage (small RBC%), non lysed red blood cell percentage (NL RBC%), and lysed red blood cell percentage (Ly RBC%). Logistic binary regression analysis was used to identify the risk factors for glomerular hematuria, and a nomogram was further constructed. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of individual indicators and the constructed nomogram for screening glomerular hematuria. Results The levels of Hy.CAST, small RBC% and Ly RBC% of glomerular hematuria group were significantly increased, while the levels of large RBC% and NL RBC% were significantly decreased, and the differences were statistically significant (Z=-11.817~-2.993, all P<0.001). The classification of RBC-INFO showed that the glomerular hematuria group was mainly charac-terized by ‘mixed hematuria’, while the non-glomerular hematuria group was mainly characterized by ‘isomorphic hematuria’ (χ2=116.963, P<0.001). Univariate risk factor analysis showed that an RBC-INFO classification was mainly ‘Mixed hematuria’,along with elevated levels of Hy.CAST, small RBC% and Ly RBC%, and decreased levels of large RBC% and NL RBC% consti-tuted risk factors for glomerular hematuria. ROC analysis showed that RBC-INFO, Hy.CAST, small RBC%, Ly RBC% and the constructed nomogram can effectively screen for glomerular hematuria, with the nomogram exhibiting the highest area under the curve (AUC). Conclusions The nomogram constructed by combining multiple indicators related to urinary sediment components (RBC-INFO, Hy.CAST, small RBC%, Ly RBC%) can be used to predict glomerular hematuria, providing an effective reference for clinical judgment of hematuria source.

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备注/Memo

备注/Memo:
作者简介：叶玉华（1996-），女，本科，技师，研究方向：临床基础检验及应用，E-mail：970776221@qq.com。
通讯作者：周静琪（1991-），女，本科，主管技师，研究方向：临床基础检验及微生物学，E-mail：394278581@qq.com。
更新日期/Last Update: 2026-03-15