Grossfeld G D, Wolf J S, Litwan M S, Hricak H, Shuler C L, Agerter D C, Carroll P R
University of California, San Francisco, School of Medicine, USA.
Am Fam Physician. 2001 Mar 15;63(6):1145-54.
The American Urological Association (AUA) convened the Best Practice Policy Panel on Asymptomatic Microscopic Hematuria to formulate policy statements and recommendations for the evaluation of asymptomatic microhematuria in adults. The recommended definition of microscopic hematuria is three or more red blood cells per high-power microscopic field in urinary sediment from two of three properly collected urinalysis specimens. This definition accounts for some degree of hematuria in normal patients, as well as the intermittent nature of hematuria in patients with urologic malignancies. Asymptomatic microscopic hematuria has causes ranging from minor findings that do not require treatment to highly significant, life-threatening lesions. Therefore, the AUA recommends that an appropriate renal or urologic evaluation be performed in all patients with asymptomatic microscopic hematuria who are at risk for urologic disease or primary renal disease. At this time, there is no consensus on when to test for microscopic hematuria in the primary care setting, and screening is not addressed in this report. However, the AUA report suggests that the patient's history and physical examination should help the physician decide whether testing is appropriate.
美国泌尿外科学会（AUA）召集了无症状镜下血尿最佳实践政策小组，以制定关于成人无症状镜下血尿评估的政策声明和建议。镜下血尿的推荐定义是在三份正确采集的尿液分析标本中的两份尿液沉渣中，每高倍显微镜视野有三个或更多红细胞。该定义考虑到了正常患者中一定程度的血尿，以及泌尿生殖系统恶性肿瘤患者血尿的间歇性特点。无症状镜下血尿的病因范围从无需治疗的轻微发现到极具意义、危及生命的病变。因此，AUA建议对所有有泌尿生殖系统疾病或原发性肾脏疾病风险的无症状镜下血尿患者进行适当的肾脏或泌尿外科评估。目前，在初级保健环境中何时进行镜下血尿检测尚无共识，本报告未涉及筛查问题。然而，AUA报告表明，患者的病史和体格检查应有助于医生决定是否进行检测。
