I. General examination.
1. Urine volume.
[Normal reference value].
Adult: 1.0-1.5L/24h, or 1mL/(h?kg body weight); Pediatric: 3-4 times more than adult according to kg body weight.
[Clinical significance]
1.Decrease in urine volume
(1) Physiological low water consumption, sweating, etc.
(2) Pathological common in nephritis, uremic renal failure, shock, dehydration, severe burns, cardiac insufficiency, etc.
2.Increased urine volume
(1) Physiological low sweating, drinking too much water, drinking strong tea, alcohol, mental tension. Pan Feng, Department of Male Urology, Nanjing Women’s and Children’s Health Hospital
(2) pathological uremia, diabetes mellitus, chronic nephritis, etc.
3. Color.
[Normal reference value].
Transparent, amber yellow.
[Clinical significance]
Gray-white cloudy turbidity, common in pus urine; red cloudy turbidity is often hematuria; soy sauce color is mostly hemoglobinuria caused by acute intravascular hemolysis; dark yellow is serving hemoglobinuria, seen in obstructive or hepatocellular xanthogranuloma; milky white is celiac disease, sometimes with small blood clots coexisting, common in hemosiderosis; turbidity is mostly inorganic salt crystalluria.
4.Density.
[normal reference value].
Normal human urine density in a day is between 1.15-1.025, and the maximum fluctuation of density can be between 1.003-1.030; newborns are between 1.002-1.004.
[Clinical significance]
Decreased urine density Commonly seen in chronic pyelonephritis, urolithiasis, chronic glomerulonephritis, and the polyuric phase of acute renal failure.
Increased urine density Most often seen in diabetes, hyperthermia, dehydration, acute glomerulonephritis, etc.
5.Acid-base.
[Normal reference value]
Urine pH (acid-base) is between 5.5-7.4, usually around 6.5.
[Clinical significance]
Urine pH is less than normal value, commonly seen in acidosis, diabetes, gout, taking acidic drugs; urine pH is greater than normal value, mostly seen in alkalosis, cystitis or taking alkaline drugs such as sodium bicarbonate, etc.
Second, urine sediment examination.
1, urine sediment examination.
[Normal reference value]
Red blood cells: 0-3/HPF; white blood cells: 0-5/HPF.
[Clinical significance]
Erythrocyte increase is mostly seen in glomerulonephritis, urinary stones, tuberculosis, and tumors.
Leukocytosis is usually seen in inflammation of the urinary tract.
Third, chemical tests.
1, urine protein: generally normal urine contains only a trace amount of protein, the protein content in the urine more than 150mg/24h is called proteinuria.
Normal urine protein in urine comes from plasma. Because the glomerular filtration membrane has a control device for protein, and the renal tubules have selective reabsorption of protein, large molecules of protein with a larger molecular weight than albumin are restricted, and although proteins with a smaller molecular weight than albumin are easy to pass, these low molecular proteins are mostly reabsorbed by the renal tubules, so normal urine protein from plasma protein is dominated by albumin.
[Normal reference values]
Qualitative: Negative.
Quantification: 10-150mg/24h urine.
[Clinical significance]
1.Physiological increase
Physiological increase refers to the temporary increase of proteinuria in a certain physiological state on the basis of no pathological changes. It is common after strenuous exercise (exercise proteinuria), change of body position (postural proteinuria), sudden cold or warm stimulation of the body, or emotional excitement of the person. Because of these conditions, the glomerular endothelial cells contract or become congested, which increases glomerular permeability. The quantitative measurement of this type of physiological protein cannot be too high.
2.Pathological increase
Pathological proteinuria, the common clinical diseases are: acute glomerulonephritis, nephrotic syndrome, pyelonephritis, chronic nephritis, hypertensive nephropathy, benzene poisoning, etc.
3, urine sugar.
Normal urine contains very little sugar, and an increase in urine sugar above the normal value is a pathological reaction.
[Normal reference value]
Qualitative: negative.
Quantitative: 0.56-5.0mmol/L, 100-900mg/(dL?24h) urine.
[Clinical significance]
Increased urine sugar is commonly seen in diabetes mellitus, nephrotic syndrome, pancreatitis, acromegaly and other diseases.
4.Bilirubin.
[Normal reference value]
Qualitative: Negative.
[Clinical significance]
Positive bilirubin is commonly found in hepatic substantive or obstructive xanthogranulomatous disease.
5.Celiac disease qualitative.
[Normal reference value]
Qualitative: negative.
[Clinical significance]
Celiac positive, mostly seen in filariasis, ruptured urinary lymphatic vessels and other diseases.
6.Urinary ketone body.
[Normal reference value]
Urine ketone body qualitative: negative.
Quantification: acetone 3mg/24h.
[Clinical significance]
Urinary ketone body positive, commonly in diabetic ketoacidosis, after strenuous exercise, violent vomiting in pregnancy, starvation, impaired digestion and absorption, dehydration, etc.
7. Iron chloride test.
[Normal reference value].
Negative.
[Clinical significance]
Light green: rapid regression of tyrosinosis.
Brown: metabolic acidosis.
8. Urobilinogen.
[Normal reference value]
Qualitative: weakly positive, urine 1:20 dilution is negative.
Quantification: 1-4mg/24h.
[Clinical significance]
Increased urinary bilirubinogen, commonly seen in viral hepatitis, hemolytic xanthogranuloma, heart failure, intestinal obstruction, internal bleeding, constipation and other diseases; decreased urinary bilirubinogen, mostly seen in long-term application of antibiotics, obstructive xanthogranuloma, etc.
9, iron-containing hemoglobin test.
[Normal reference value].
Negative.
[Clinical significance]
Positive: paroxysmal sleep hemoglobinuria, other intravascular hemolysis?BR>9, Mohs concentration test:
[Normal reference value]
Maximum daily urine density > 1.018.
[Clinical significance].
The test is used to determine renal tubular reabsorption function.
10, Occult blood test.
[Normal reference value]
Negative.
[Clinical significance]
Positive occult blood test, etc., seen in sericea, malaria, typhoid fever, large burns complicated by hemoglobinuria, arsenic, benzene, lead poisoning and hemoglobinuria caused by poisonous snake bites.
Fourth, urine microscopic examination.
1. Tube type.
[normal reference value].
Generally 0 in the urine, a small amount of transparent tubular type can be seen after strenuous exercise.
[Clinical significance]
Increased granular tubular type is seen in acute and chronic glomerulonephritis; increased transparent tubular type 9 is commonly seen in renal parenchymal damage; increased erythrocyte tubular type is mostly seen in renal hemorrhage and acute glomerulonephritis; increased fatty tubular is mostly seen in chronic nephritis nephrotic syndrome.
2. Leukocytes.
[Normal reference value].
5/high magnification (HPF).
[Clinical significance]
Leukocytosis is common in bacterial inflammation, such as acute pyelonephritis; non-bacterial inflammation, such as acute glomerulonephritis can sometimes also appear leukocytosis.
3. Erythrocytes.
[Normal reference value]
Usually no erythrocytes, or 0-2/HPF.
[Clinical significance]
Increased red blood cells means hematuria. Hematuria is commonly seen in acute glomerulonephritis, acute pyelonephritis, urinary stones, renal tuberculosis, hemophilia, etc.
4. Small round epithelial cells.
[Normal reference value].
0 in normal urine, or a very small amount.
[Clinical significance]
Increased small round epithelial cells are commonly found in renal tubular damage.