Fogazzi Giovanni B, Garigali Giuseppe
Research Laboratory of Urine, Division of Nephrology, Ospedale Maggiore, Milan, Italy.
Curr Opin Nephrol Hypertens. 2003 Nov;12(6):625-32. doi: 10.1097/00041552-200311000-00009.
The examination of urine sediment is a diagnostic test which is frequently neglected by nephrologists. With this review the authors wanted to demonstrate that it can provide useful and relevant information in a wide spectrum of clinical situations.
The authors reviewed the main contributions dealing with urine sediment examination, published in international journals in the period from January 2002 to April 2003. After a section on methodological aspects, they described the importance of urine sediment examination in various diseases of the urinary tract. These included bladder B-lymphoma, systemic histoplasmosis, urate nephropathy, Fabry disease, myeloma cast nephropathy, giant cell arteritis, and lupus nephritis. The significance of 'decoy cells' in the urine as a marker of polyomavirus BK reactivation was also discussed, both in renal transplantation and other conditions such as solitary pancreas transplantation, chronic lymphatic leukaemia, and HIV infection. In the section devoted to urine sediment changes caused by drugs the authors dealt with leukocyturia induced by indinavir, and crystalluria, which can follow amoxycillin and acyclovir administration. Finally, they reported on the utility and limits of flow cytometry for the automated analysis of urine sediments.
The review of the recent literature on urine sediment examination shows that this test has important clinical implications in a large spectrum of diseases. Therefore, it should be more widely used by nephrologists.
尿液沉渣检查是一项诊断性检查，但肾科医生常常忽视这项检查。通过本综述，作者旨在证明尿液沉渣检查能在广泛的临床情况下提供有用且相关的信息。
作者回顾了2002年1月至2003年4月期间发表在国际期刊上有关尿液沉渣检查的主要文献。在阐述方法学方面的内容后，他们描述了尿液沉渣检查在各种泌尿系统疾病中的重要性。这些疾病包括膀胱B淋巴瘤、系统性组织胞浆菌病、尿酸盐肾病、法布里病、骨髓瘤管型肾病、巨细胞动脉炎和狼疮性肾炎。文中还讨论了尿液中“诱饵细胞”作为多瘤病毒BK再激活标志物的意义，涉及肾移植以及其他情况，如单独胰腺移植、慢性淋巴细胞白血病和HIV感染。在关于药物引起的尿液沉渣变化的章节中，作者探讨了茚地那韦引起的白细胞尿以及阿莫西林和阿昔洛韦用药后可能出现的结晶尿。最后，他们报告了流式细胞术在尿液沉渣自动分析中的实用性和局限性。
对近期尿液沉渣检查文献的综述表明，这项检查在众多疾病中具有重要的临床意义。因此，肾科医生应更广泛地使用该项检查。
