Four seas network: speaking of going to the hospital for examination, in addition to blood routine, urine routine is also the most common clinical examination item. There are many items that can be tested for urine. According to different hospital equipment, the most common ten to twenty (or more) tests can be completed at one time, which takes only a few minutes. We usually combine the inspection results of the automatic urine analyzer with the inspection results of the artificial microscope, which is called routine urine inspection.
1、 What kind of circumstances need to do urine routine examination
Urine is the end product of blood after renal metabolism. The composition and properties of urine can reflect the metabolic status of the body and are affected by the functional status of various systems of the body. Therefore, urine test can not only reflect the problems of urinary system, but also have important reference value for the diagnosis of other system diseases.
When the urinary system has inflammation, stone, tuberculosis, tumor, renal transplant rejection, renal failure and other conditions, the composition of urine will change; when some diseases cause the change of blood composition, the corresponding changes of composition may also appear in urine, such as diabetes, pancreatic inflammation, jaundice and other conditions.
2、 How to interpret the common examination items of urine routine
1. Urine pH
That is, the pH value of urine. PH values will be reduced in cases of acidosis, hyperthermia, gout, diabetes and so on. * pH will increase when alkalosis, urinary retention and cystitis are involved. Taking medicine can also affect pH value, such as vitamin C, amine chloride can make urine acidic, sodium bicarbonate can make urine alkaline.
2. Specific gravity of urine
It can roughly judge the concentration and dilution function of kidney to urine. When the body is short of water and urine, diabetes mellitus, acute glomerulonephritis and nephrotic syndrome will increase the proportion of urine; when drinking a lot of water, chronic glomerulonephritis and chronic renal failure, the proportion of urine may decrease.
3. Urine protein
Under normal circumstances, there should be no protein in the urine. If positive protein is detected in urine, it can be seen in the following situations:
1. Pseudoalbuminuria: there is no problem with the kidney itself, but there are blood, pus, mucus and other components in the urine which lead to positive protein qualitative test. For example, cystitis, urethritis, urinary tract bleeding, urinary tract mixed with vaginal secretions and so on. After treatment, it can return to normal soon.
2. Physiological albuminuria: when the body is stimulated by strenuous exercise, fever, cold, mental tension, sympathetic excitation, etc., it may cause the temporary appearance of protein in urine. Generally, it is light and lasts for a short time. When the inducement is removed, it will disappear.
3. Pathological proteinuria: it is mainly seen in various kidney diseases, and some extrarenal diseases can also be caused. Most will persist.
All of the above indicate that if protein is detected in urine, it should be rechecked frequently.
4. Urine glucose
The normal urine glucose test should be negative. When the glucose content in the blood is significantly higher than that of the kidney, a large amount of glucose will appear in the urine. That's the name of diabetes. But don't think that if the urine sugar is negative, there will be no diabetes. The essence of diabetes is still the rise of blood sugar. When urine sugar also appears, it can only indicate that the blood sugar is too high. So when the urine sugar is positive, the blood sugar level should be detected in time.
Sometimes when the blood sugar content is normal, urine sugar will also appear. This may be due to renal lesions, resulting in a decrease in the ability to absorb glucose. Common in chronic nephritis, nephrotic syndrome and other diseases.
5. Urinary ketone body
Under normal circumstances, the urine ketone body should also be negative. When the metabolism of glycolysis in vivo is insufficient, fat decomposition is active but oxidation is not complete, which can produce a large number of ketones, which are excreted through urine. This situation can be seen in high fever, severe vomiting, diarrhea, long-term hunger, fasting, excessive diet, hyperemesis of pregnancy, alcoholic hepatitis, cirrhosis, etc. When diabetic patients appear urinary ketone body, we should be alert to ketoacidosis.
6. Red blood cells and occult blood
The meaning of these two items is the same. Under the microscope, the number of red blood cells is generally less than 3 / HP, and occult blood should also be negative. When the value of these two items is relatively high, it can be called hematuria.
Hematuria may be caused by kidney stone, urinary system tumor, renal tuberculosis, acute cystitis, etc., or glomerular destruction caused by various nephritis.
If there are positive RBC and occult blood in urine, regular reexamination is also necessary.
7. Leukocytes
Microscopically, the number of white blood cells is 0-5 / HP. When white blood cells increase significantly, it is generally indicated that there is urinary tract infection. For example, pyelonephritis, cystitis, urethritis, renal tuberculosis, etc. When the adult female reproductive system has inflammation, vaginal secretions are easy to mix into the urine, so pay attention to the identification.
Every hospital's urine routine report may have some different items, which can not be mentioned one by one.
There are also some testing items that are quantitative testing, and specific values will be given, followed by normal reference range, which is convenient for us to compare. Understand these, understand a urine routine test sheet should be basically no problem.
3、 What should be paid attention to when checking the urine routine
Because urine routine is usually collected by patients themselves, if the samples are not collected properly, it may affect the accuracy of the test results, the following matters need to be noted.
1. Urine routine can be tested at any time without fasting or other special requirements. But the result of morning urine test is the most accurate.
2. The samples should be tested as soon as possible, and the components will be affected if they are placed too long. If it is more than 2 hours, it is better to collect samples again.
3. Urine is very easy to be contaminated by urethral secretion, such as vaginal secretion of women, and semen and prostate fluid of men. Therefore, before collecting urine, it is better to wash and disinfect the external genitals if possible. When taking urine, do not discard the first part, take the middle part and the last part.
4. If you are taking some drugs at the same time when testing the urine routine, you should explain the situation to the doctor to help the doctor analyze the results accurately.
5. Because of the various factors mentioned above, the results of urine routine may fluctuate greatly. When an occasional abnormality is detected, it is not necessary to be too nervous, and the real situation can be reflected only after repeated reexamination.