活体染色法在筛查尿液诱饵细胞中的应用
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1.内蒙古包钢医院 医学检验科;2.北京协和医院

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Application of in vivo staining in screening decoy cells in urine samples
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    摘要:目的 用2种活体染色法筛查长期使用免疫抑制剂的肾移植术后患者尿液中的多瘤病毒感染后的细胞,即“诱饵细 胞”。 方法 留取2019年1月至2020年4月内蒙古包钢医院106例肾移植患者(服用免疫抑制剂在3个月以上)的尿液标 本,用未染色直接镜检法、沙黄-结晶紫(SM)染色法、阿利新蓝-派洛宁(Sternheimer,S)染色法检查尿液中诱饵细胞,对筛查出 诱饵细胞的尿液标本做 BK 病毒(BKV)和JC病毒(JCV)核酸检测进行确证。 结果在106例肾移植术后患者的尿液标本中, 用未染色直接镜检法检出12例诱饵细胞,阳性率11.3%而使用 SM 染色法或 S 染色法检出21例诱饵细胞,阳性率19.8%;在21例检出诱饵细胞的尿液标本中,BKV 和(或)JCV核酸阳性符合率为95.2%,其中 BKV 核酸阳性6例,占28.6%,JCV 核酸阳 性 10 例,占47.6%,BKV 和 JCV 核酸同时阳性4例,占19.0%。 结论 SM 染色法、S 染色法 2 种活体染色法是操作简单、快速 而有效的尿诱饵细胞检测方法,在筛查肾移植术后患者因长期使用免疫抑制剂而感染多瘤病毒方面有着重要意义。

    Abstract:

    ABSTRACT: Methods We collected the urine samples From January 2019 to April 2020 in Inner Mongolia Baogang Hospital of 106 patients who had been using immuno-suppressants for more than 3 months after kidney transplantation surgery, and the decoy cells were screened by direct microscopic examination without staining, SM staining and S staining, which were later confirmed by the amplification of the nucleic acid of BK virus (BK)and JC virus(JC), whose infection was believed to have caused the specific morphological change of the cells. Results Among 106 patients,decoy cells were detected in 12 cases of the urine samples by direct microscopy without staining, The positive rate were 11.3%, 21 cases of the urine samples by SM staining and S staining, The positive rate were 19.8%, among which the positive rate of BKV and (or) JCV viral nucleic acid was 95.2%,6 cases were positive for BKV nucleic acid (28.6%),10 cases were positive for JCV nucleic acid(47.6%), 4 cases were positive for BKV and JCV nucleic acid(19.0%). Conclusion SM staining and S staining are simple, rapid and effective methods for detecting urinary decoy cells in the urine. It has important clinical significance in screening patients infected with human polyoma virus after kidney transplantation surgery due to long-term use of immuno-suppressants.

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闫立志,张时民.活体染色法在筛查尿液诱饵细胞中的应用[J].临床检验杂志,2020,(10):738-740

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  • 收稿日期:2020-08-07
  • 最后修改日期:2020-11-09
  • 录用日期:2020-11-09
  • 在线发布日期: 2021-03-24
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