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[基层医疗中的实验室检查:“基本实验室检查”(1). 尿液分析]

[Laboratory tests in primary care medicine: "essential laboratory tests" (1). Urinalysis].

作者信息

Sekiguchi S, Kugai N, Miyoshi K, Hayashi K, Mori S, Takemura Y, Tamai S

机构信息

Department of Laboratory Medicine, National Defense Medical College, Tokorozawa.

出版信息

Rinsho Byori. 1990 Nov;38(11):1286-90.

PMID:2273571
Abstract

Japan Society of Clinical Pathology has formed a committee dealing with "lab. tests in primary care medicine". As the first step, they made "Essential Lab. Tests" which were composed of simple qualitative bed-side tests such as urinalysis, Complete blood count (CBC: Hb, Ht, WBC, RBC), CRP, or ESR (Erythrocyte sedimental rate), A/G ratio and biochemical tests if necessary (Table 1). We have performed "Essential Lab. Tests" on 1,026 outpatients who visited General Medicine Clinic for the first time. They consisted of 456 male (age 13-81), and 526 female (age 10-85). This report is the result of urinalysis from "Essential Lab. Tests" of 1,026 patients. 1) The result showed that overall positivity of the urinalysis was 21.3% (when more than one item of the qualitative tests was positive). 2) There was distinctive difference in the positivity of the urinalysis between the sex; i.e. protein and glucose were about twice frequently positive in male, where as occult blood and WBC (Esterase reaction) were 2-3 times more positive in female. 3) Urine protein shows positive in the individual 10-20 yrs old and more than 50 yrs old in both sexes. 4) Glucose was positive in over 40 yrs in male, and occult blood, 40-50 yrs or older in male. 5) WBC shows positive in all age groups in female and 50 yrs or older in male. 6) Positive WBC patients did not necessarily reflect urinary infection in female but nitrites roughly corresponded with urinary WBC in male of 50 yrs or older, meaning probable urinary infection associated with prostatic hypertrophy. 7) Abnormality of urinary sediment corresponded to the positive occult blood and WBC Erastase. 8) Urinalysis is an useful method of screening in primary care medicine.

摘要

日本临床病理学会成立了一个处理“基层医疗中的实验室检查”的委员会。第一步,他们制定了“基本实验室检查”,包括简单的定性床边检查,如尿液分析、全血细胞计数(CBC:血红蛋白、血细胞比容、白细胞、红细胞)、CRP或血沉(红细胞沉降率)、白蛋白/球蛋白比值,必要时还包括生化检查(表1)。我们对首次到普通内科门诊就诊的1026名门诊患者进行了“基本实验室检查”。其中包括456名男性(年龄13 - 81岁)和526名女性(年龄10 - 85岁)。本报告是对1026名患者“基本实验室检查”中尿液分析的结果。1)结果显示,尿液分析的总体阳性率为21.3%(当定性检查中一项以上呈阳性时)。2)尿液分析的阳性率在性别上存在显著差异;即蛋白质和葡萄糖在男性中的阳性频率约为女性的两倍,而潜血和白细胞(酯酶反应)在女性中的阳性率是男性的2 - 3倍。3)尿液蛋白在10 - 20岁以及50岁以上的男女个体中呈阳性。4)葡萄糖在男性40岁以上呈阳性,潜血在男性40 - 50岁及以上呈阳性。5)白细胞在女性所有年龄组中呈阳性,在男性50岁及以上呈阳性。6)女性白细胞阳性患者不一定反映泌尿系统感染,但亚硝酸盐大致与50岁及以上男性的尿液白细胞相对应,意味着可能与前列腺肥大相关的泌尿系统感染。7)尿沉渣异常与潜血和白细胞酯酶阳性相对应。8)尿液分析是基层医疗中一种有用的筛查方法。

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