Urine routine Urine, human urine, is the result of the body’s metabolism, through the urinary system and urinary tract out of the body. The production of urine depends on the glomerular filtration and reabsorption secretion of the renal tubules and collecting ducts. Abnormalities in urine can indicate the health status of the body. As one of the three major routine tests, urine routine is an auxiliary test for many diseases. General urine tests include urine color, transparency, specific gravity, urine pH, urine white blood cells, nitrite, protein, glucose, urine ketone bodies, urine bile, urine hemoglobin and other content. Color The color of normal human urine is light yellow, but also with the amount of water consumption, activity, dietary changes can be slightly changed. Common abnormal urine colors include the following: Dark tea-colored urine: bilirubin positive, mostly seen in hepatocellular jaundice, obstructive jaundice, etc. Red urine: hematuria, which can be seen in urinary stones, tumors, infections (including tuberculosis), glomerulonephritis and so on. Of course, some drugs can also cause red urine, such as aminopyrine, phenytoin sodium, rifampicin, etc. Therefore, when you find hematuria, you must first exclude the influence of these “destructive molecules”, and then combine with the patient’s clinical symptoms to exclude them one by one, and look for the cause of the disease. Beer-like to soy sauce-colored urine: hemoglobinuria, seen in serosanguineous disease. Milky white urine, celiac disease, pus urine: common in filariasis, or the urine contains a large number of inorganic salt crystals. Transparency Normal fresh urine, most of which is clear and transparent, in addition to placing for a long time and women’s urine can be slightly turbid, cloudy urine is mostly seen in urate crystals, celiac disease, pyuria, hematuria. The normal range of pH is 4.6-8.0. The pH of the urine depends greatly on the type of diet, medications taken, and the type of disease. Low levels are seen in diabetic acidosis, starvation, severe diarrhea, respiratory acidosis, and fever. Higher levels are seen in severe vomiting, persistent hyperventilation, and urinary tract infections. Specific gravity Normal range: 1.005-1.030. Specific gravity is affected by age, water intake and sweating, and is low in infants and young children. The specific gravity of urine mainly depends on the concentration function of the kidneys, so it can be used as one of the renal function tests. Increased specific gravity: seen in acute nephritis, high fever, cardiac insufficiency when urine is low; seen in diabetes mellitus when urine is increased. Decrease in specific gravity: seen in chronic glomerulonephritis, renal insufficiency, uremia, heavy drinking. Leukocytes: Normal urine microscopy does not contain more than 5 leukocytes; if a large number of leukocytes are present, the possibility of urinary tract infection should be considered. However, it should be noted that there are many factors affecting urine leukocytes such as crystals, small round epithelial cells, yeast, trichomonas and other components that can cause leukocytes to increase, resulting in false positives, while jaundiced urine and urine left in the urine for a long period of time can lead to a decrease in the number of leukocytes, resulting in false negatives. Therefore, it is not possible to judge urinary tract infection solely from positive urine leukocytes, and it is necessary to combine it with the nitrite results described below. Nitrites Normally, urine nitrites are negative. Positive urinary nitrite results are common in pyelonephritis caused by Escherichia coli (about two thirds of cases), as well as in urinary tract infections, cystitis, bacteriuria, and so on. Urine nitrite specificity can be up to 80%, its auxiliary diagnosis of urinary tract infections has a high value, nitrite is positive for the basic preliminary judgment for urinary tract infections. If the urinary tract infection bacteria (such as positive bacteria) can not make nitrate reduction to nitrite, or urine in the bladder in a short period of time, or the lack of nitrate in the urine, will also produce negative results, need to pay attention to. Erythrocytes Occasional red blood cells may be present in normal urine, but not more than 3. If more red blood cells are present, they may be discharged from bleeding in the kidneys or urinary tract, and should also be considered to be caused by blood circulation disorders. Sometimes urine occult blood may be positive, but urine red blood cells negative, this is the urine red blood cells by the osmotic pressure in the urine and other factors, and finally rupture. Therefore, it is not purely from hematuria or red blood cells in the urine to determine where the lesion occurs, if the patient has hematuria, and then do a urine erythrocyte morphology test is of great significance in determining the source of hematuria. At the same time, the combination of the patient’s clinical manifestations, urinary protein and imaging results will help to comprehensive analysis and judgment. Urine protein Normal people occasionally have a small amount of protein in the urine, including albumin, globulin and some other small molecular weight proteins secreted by the renal tubules. Normal urine routine examination of urine protein is negative, the total amount of protein in the 24-hour urine is less than 150 mg, of which albumin does not exceed 30 mg. There are many causes of proteinuria, to diagnose pathological proteinuria, it is also necessary to exclude the following factors: Functional proteinuria: mental stress, strenuous exercise, low temperature stimulation, most commonly seen in adolescents. Postural proteinuria: negative when lying down, positive when standing for too long, mostly seen in adolescents. Occasional proteinuria: the urine mixed with the reproductive system excretion, can appear false positive urine protein. The opposite is true when the patient has been injected with a large amount of penicillin, which can lead to a false negative for urine protein. Urine protein test is also an important indication for patients with renal disease, if the patient is determined to be positive for urine protein with clinical diagnostic value, can be further done 24-hour urine protein quantitative examination. Urine ketone body The qualitative test of ketone body in normal people is negative. In starvation, various causes of glucose metabolism disorders, lipolysis increased and diabetic ketoacidosis, due to the production of ketone bodies faster than the rate of tissue utilization, ketonemia can occur, followed by ketonuria. Positive urine ketone bodies are often associated with diabetes, pregnancy, malnutrition, and chronic diseases such as diabetic ketoacidosis. It may also be caused by severe diarrhea, vomiting, starvation, chloroform, ether after anesthesia, phosphorus poisoning; administration of biguanide hypoglycemic drugs. Urinary bilirubin, etc. Urinary bilirubin, urobilinogen and urobilin are mainly used as the basis for the differential diagnosis of jaundice, and their results need to be synthesized together for clinical guidance. Tubular urine There is no tubular pattern in normal urine, or a few transparent tubular patterns are occasionally seen. The presence of tubular pattern in urine, especially granular tubular pattern and cellular tubular pattern is a sign of substantial renal lesions, which is important for diagnosis. Transparent tubular pattern: it can be seen in a small amount of transparent tubular pattern in urine when there is a mild or temporary functional change of the kidney, such as strenuous exercise, high fever and cardiac insufficiency; it can be seen in a large amount of transparent tubular pattern when there is a substantial lesion of the kidney. Erythrocytic tubular pattern: seen in acute glomerulonephritis, acute tubular necrosis, renal hemorrhage and acute rejection reaction of renal transplantation. Leukocyte tubular pattern: seen in the kidney with purulent inflammation, such as acute pyelonephritis, interstitial nephritis. Granular tubular pattern: seen in renal organic lesions, such as chronic nephritis, renal tubular injury caused by drug poisoning. Waxy tubular pattern: seen in severe glomerulonephritis, chronic nephritis advanced stage, its appearance suggests that the kidney has long-term and serious lesions. Fatty tubular pattern: it is the product of fatty degeneration of renal epithelial cells, which is seen in chronic nephritis and lipoid nephropathy. In summary, such a simple and easy test provides so much information that it is worth utilizing. It is important to note that because urine is easy to obtain, it also has a large number of interference factors, so the specimen should be taken with special attention.