Routine urine test is one of the most commonly used tests and is a basic indicator of the health status of the body. Routine urine test sheets can directly and rapidly reflect the urinary system, kidney metabolism and other conditions. Therefore, regular routine urine examination has strong reference value and clinical significance for timely detection of urinary system diseases and kidney damage. On a routine urine test sheet, if some items are followed by a “+” sign (or “++”, “+++”, indicating different degrees), this is called a positive result in medical terms. On the contrary, a “-” sign is called a negative result. Positive results are usually a sign of urinary tract disease. A large number of white blood cells (WBC + + + – + + + +) reported on the report card is mostly indicative of urinary tract infection; a large number of red blood cells (RBC + – + + + + +) in the urine indicates urinary tract stones, tumors, infection or urinary tract injury. If there is a tubular type in the urine test, it means that there is some damage to the kidney, which is common in acute and chronic nephritis, pyelonephritis or nephrotic syndrome, etc.
The indicators and specific clinical significance on the urine routine laboratory test are as follows.
1, urine leukocytes (LEU)
Normal human centrifugal urine leukocytes do not exceed 5 per high magnification field of view. More than 5 per high-powered field of view, called leukocyte urine. When a large number of leukocytes, it is called pus urine.
Normal reference value: 0-5/HP
Clinical significance: Increased, seen in urinary tract infections such as pyelonephritis, cystitis, urethritis, etc. Chemical detection of urine leukocytes and red blood cells only play a screening role, the clinical diagnosis is based on the results of microscopic examination.
2.Urine ketone body (Ket)
Normal reference value: Negative (-)
Clinical significance: Positive, seen in severe diabetes, pregnancy poisoning, prolonged fasting, vomiting, diarrhea, dehydration or excessive fat intake.
3.Urine nitrite (NIT)
Normal reference value: Negative (-)
Clinical significance: Positive, suggesting the possibility of urinary tract stones or infection. If the specimen is left for a long time, it may also be false positive.
4.Urobilinogen (UBG), Urobilirubin (BIL)
Normal reference value: Negative (-)
Clinical significance: Positive urine bilirubin and urine bilirubin mostly suggest the presence of jaundice, which helps in the diagnosis and differential diagnosis of jaundice. However, sometimes there are false positives, which need to be combined with serum bilirubin assay to determine.
5.Urine protein (PRO)
Normal reference value: Negative (-)
Clinical significance: Normal urine routine examination is generally without protein, or only a trace. Increased and persistent urine protein is mostly seen in kidney disease. However, transient proteinuria may also occur with fever, strenuous exercise, and during pregnancy. Therefore, it is necessary to follow up and observe when there is protein in the urine to clarify the cause.
6.Glucose (Glu)
In normal people, a transient increase in urine glucose can occur when taking a large amount of glucose solution within a short period of time, after exercise, or during pregnancy.
Normal reference value: Negative (-)
Clinical significance: Positive. Positive urine glucose should be analyzed in conjunction with clinical analysis. It may be diabetes mellitus or nephrogenic glycosuria due to lowered renal glucose threshold, and should be clearly diagnosed in conjunction with blood glucose testing and other test results. Since vitamin C and aspirin in urine can affect the urine sugar results, it is necessary to stop taking vitamin C and aspirin 24 hours before checking urine sugar.
7.Urine specific gravity (SG)
The specific gravity of urine is low in infants and children. The specific gravity of urine is influenced by age, water intake and sweating. The specific gravity of urine depends mainly on the concentration function of the kidneys, so the determination of the specific gravity of urine can be used as one of the indicators to detect kidney function.
Normal reference value: 1.010-1.030
Clinical significance: Decreased urine specific gravity: common in chronic pyelonephritis, urolithiasis, chronic glomerulonephritis, polyuric phase of acute renal failure, etc. Increased urine specific gravity: seen in hyperthermia and dehydration, acute glomerulonephritis, cardiac insufficiency. Proteinuria and diabetic patients also have an increased specific gravity of urine.
8, urine pH (pH)
The pH (acidity/alkalinity) is generally around 6.0. Normal urine is weakly acidic. Urine pH depends to a large extent on the type of diet, the drugs taken and the type of disease.
Normal reference value: 5.0-8.0
Clinical significance: urine pH is less than normal: common in acidosis, diabetes, gout, taking acidic drugs; urine pH is greater than normal: mostly seen in alkalosis, cystitis or taking alkaline drugs such as sodium bicarbonate, etc.
9, urine red blood cells (RBC)
Red blood cells can be occasionally seen in normal human urine, and no more than 3 per high magnification field of view after centrifugal precipitation.
Normal reference value:0-3/HP
Clinical significance: Commonly found in urinary stones, infections, tumors, etc. Strenuous exercise and impaired blood circulation, etc., can also lead to increased glomerular permeability and the appearance of protein and red blood cells in the urine.
10.Urine occult blood (ERY)
Normal reference value: Negative (-)
Clinical significance: negative urine occult blood test in normal conditions. If urine occult blood is positive with protein, first consider kidney disease, bleeding disease, further kidney function test can be done; if urine protein is negative, the site and nature of bleeding should be identified in the relevant specialist. It is generally believed that the lower urinary tract bleeding may not be obvious because the red blood cells are not destroyed. Urine occult blood also has false positive times, then should be combined with urine sediment examination to clarify its true or false, if necessary, can do urine red blood cell bit phase examination.
11.Urinary tubular pattern (KLG)
Normal reference value: Negative (-)
Clinical significance: The presence of tubular pattern in urine, especially granular tubular pattern and cellular tubular pattern are signs of substantial kidney damage.
12.Urine epithelial cells (SPC)
Normal reference value: negative (-)
Clinical significance: A small amount of epithelial cells in urine is of little clinical significance. When large numbers appear, if contamination by vaginal secretions can be excluded, the presence of inflammation of the urinary system should be considered. At this point, the source of the epithelial cells can be determined if a morphological examination of urinary epithelial cells is added.