Deputy Chief Technician, General Hospital of PLA, Chief Physician Cong Yulong.

Urine routine analysis is a routine examination we do. Most hospitals use urine analyzers for testing. There are 10, 1 1 or 12 at present, and the report format is not uniform, with "+"(positive) and "-"(negative), and there are figures, and the units of testing items are different. What about the urine test report?

Urine routine items can be roughly divided into four categories: nephropathy, diabetes, urinary tract infection and other diseases.

Nephropathy project

Acidity (pH), specific gravity (SG), occult blood or red blood cells (BLD, ERY), PROtein (pro) and COLor (col). Normal reference values are: 4.6 ~ 8.0, 1.005 ~ 1.030, positive, negative, light yellow to dark yellow. The changes of these indexes may suggest renal function damage.

Diabetes project

PH value, protein, specific gravity, sugar (GLU) and ketone body (KET). The detection of these indicators is helpful to diagnose related complications and whether some organs of the body are damaged, such as ketosis. Under normal circumstances, urine sugar and ketone bodies are negative.

Urinary infection project

White blood cells (WBC), occult blood or red blood cells, nitrite (NIT), color and turbidity (TUR). When the urinary system is infected by bacteria, white blood cells and red blood cells often appear in urine, and the color or turbidity of urine also changes, and nitrite is sometimes positive. The chemical detection of urine white blood cells and occult blood or red blood cells only plays a screening role, and the clinical diagnosis is based on the results of microscopic examination.

Other disease items

Mainly pH, specific gravity, bilirubin (BIL), URO, color and other indicators. Bilirubin and urine urobilinogen reflect the ability and quantity of liver to metabolize heme. Under normal circumstances, urine bilirubin is negative and urine urobilinogen is weakly positive. When the above indicators rise, it often suggests jaundice and yellow-green urine.

Some items in the urine routine analysis test sheet are followed by "+"or "++"or numbers, indicating different degrees, which are medically called positive results; Conversely, "-"is called a negative result. When reading the report, we should objectively analyze the report, because there are many interference factors that affect the accuracy of the test results, such as diet factors and some interference substances in urine. Please don't be too nervous and worried when the urine routine examination is abnormal; Similarly, don't be blindly optimistic when there are test results that are inconsistent with clinical manifestations. Be sure to cooperate with clinicians for further examination and analysis, so as not to delay the diagnosis of the disease.

What do you think of the urine routine examination report?

Routine urine examination is an important item of health examination, which can not only reflect urinary system diseases, but also be of great significance for screening diabetes, icteric hepatitis, biliary obstruction and other diseases.

1. Urine protein (PR0)

Normal urine routine examination generally has no protein or only trace. Increased and persistent urinary protein is more common in kidney diseases. But fever, strenuous exercise and pregnancy occasionally cause urinary protein. Therefore, it is necessary to follow up and observe the causes of urinary protein.

Step 2 urinate sugar

The positive urine glucose should be combined with clinical analysis, which may be caused by diabetes or renal diabetes, and the diagnosis should be made by combining blood glucose test and related examination results. Because vitamin C and aspirin in urine will affect the results of urine sugar, vitamin C and aspirin should be stopped 24 hours before urine sugar test.

3. Urine red blood cells (RBC)

Under each high-power microscope, there are more than 5 red blood cells in urine, which is called microscopic hematuria; When there are a large number of red blood cells, it is called "gross hematuria", which can be seen in inflammation, infection, stones, tumors and so on. Urinary system. Pay more attention to it, go to urology department for further examination immediately, and make clear the location and cause of hematuria.

4. Urine leukocytes

Under each high-power microscope, there are more than five white blood cells in urine, which is called white urine. When there are a large number of white blood cells, it is called pyuria, which indicates urinary tract infection, such as pyelonephritis, cystitis and urethritis.

5. Urine epithelial cells (SPC)

There are a few epithelial cells in urine, which has little clinical significance. When there are a large number of cases, if we can eliminate the pollution of vaginal secretions, we must consider the existence of urinary system inflammation. At this time, if the morphological examination of urine epithelial cells is added, the source of epithelial cells can be determined.

6. Catheter type (KLG)

Urine casts, especially granular casts and cell casts, are signs of renal parenchymal lesions.

7. Urine occult blood (ERY)

Normal urine occult blood test is negative. If the urine occult blood and protein are positive at the same time, renal diseases and hemorrhagic diseases should be considered first, and further renal function examination can be done; If the urine protein is negative, you should go to the relevant specialist to find out the location and nature of the bleeding. It is generally believed that occult blood is not obvious because red blood cells are not destroyed.

8. Urogenin (UBG) and Urinary Bilirubin (BIL)

The positive urine urobilinogen and bilirubin suggest the existence of jaundice, which is helpful for the diagnosis and differential diagnosis of jaundice.

9. Urinary nitrite (NIT) Urinary nitrite is mainly used for screening tests of urinary tract infections. Nitrite in fresh urine is negative, and the specimen can be false positive if it is left for too long or bacteria grow and reproduce.

Why are the test results of the two hospitals different?

Dr. Zhang Guohua, Clinical Laboratory, Peking University First Hospital

Some people always want to make a comprehensive judgment on the test results of multiple medical units to determine whether they are healthy or not. However, sometimes the laboratory tests in one hospital are normal, but they are abnormal in another hospital. So, why is this happening? There are many reasons.

First of all, the most common reason is that the medical examiner did not carefully read the Instructions for Physical Examination and took improper samples, so that the samples tested by the same person twice were actually different. For example, fasting before blood drawing has a great influence on the determination results (such as blood sugar, blood lipid, etc.). ); Whether it is in a quiet state before blood drawing, because some items such as transaminase will increase after strenuous exercise; Whether the urine taken is morning urine or not, because the results of the first urine test in the morning are very different from those of the usual random urine test.

Secondly, the physical condition of the medical examiners was inconsistent during the two physical examinations. For example, whether the medical examiner has taken drugs, some drugs will affect the measurement items (such as transaminase, creatinine, etc. ), or whether the female medical examiner is in the menstrual period.

In addition, it is also possible that the determination methods and instruments of the two hospitals are different, resulting in different results. Another possibility is that medical workers are not responsible enough to make the wrong specimens.

If the test results of the two hospitals are inconsistent, the medical examiner need not panic, and can ask the medical staff to make a reasonable explanation, and correctly take samples under the guidance of the medical staff, and cooperate with them to find out the reasons and show the true nature of their physical condition.