Fettman M J
Department of Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523.
J Am Vet Med Assoc. 1989 Oct 1;195(7):972-6.
The clinical problems and results of urinalyses of 500 dogs were reviewed and summarized to compare the sensitivities for detection of abnormalities indicative of urinary system disease among qualitative (sulfosalicylic acid [SSA]), quantitative (Coomassie brilliant blue [CBB]), and indexed (urinary protein/creatinine ratio [U(P/C)]) determinations of urinary protein loss vs microscopic examination of urine sediment. False-negative rates for the detection of microscopically abnormal urine specimens were 5.4% for SSA greater than or equal to 1+, 8.5% for CBB greater than or equal to 1.0 mg/ml, 9.7% for U(P/C) greater than or equal to 1.0, and 7.7% for CBB + U(P/C). A discriminatory U(P/C) value of 2.0 would have excluded dogs with clinically relevant proteinuria in the lower ranges. Proteinuria was not detected in 4.4% (22/500) of the specimens in which important numbers of leukocytes or bacteria were observed. False-negative rates for combined interpretation of quantitative protein concentration and U(P/C) were not significantly different (P greater than 0.10) from SSA alone. Degrees of azotemia were higher (high serum creatinine concentration, P greater than 0.10 and high serum urea nitrogen concentration, P less than 0.05) and prevalence of chronically diseased dogs was greater (P less than 0.005) in dog categories with higher U(P/C) values. More quantitative determinations of urinary protein loss as a screening test offer potential labor-saving and diagnostic advantages in the identification of urinary disease over more qualitative routine screening methods.
回顾并总结了500只犬尿液分析的临床问题及结果,以比较定性(磺基水杨酸[SSA])、定量(考马斯亮蓝[CBB])和指数法(尿蛋白/肌酐比值[U(P/C)])测定尿蛋白丢失与尿沉渣显微镜检查在检测泌尿系统疾病异常方面的敏感性。对于显微镜下异常的尿液标本,SSA≥1+时假阴性率为5.4%,CBB≥1.0mg/ml时为8.5%,U(P/C)≥1.0时为9.7%,CBB+U(P/C)时为7.7%。U(P/C)值为2.0时可排除低范围临床相关蛋白尿的犬。在观察到大量白细胞或细菌的标本中,4.4%(22/500)未检测到蛋白尿。定量蛋白浓度和U(P/C)联合解读的假阴性率与单独使用SSA相比无显著差异(P>0.10)。U(P/C)值较高的犬类中,氮质血症程度更高(高血清肌酐浓度,P>0.10;高血清尿素氮浓度,P<0.05),慢性病犬的患病率更高(P<0.005)。与更多定性常规筛查方法相比,更多地采用尿蛋白丢失的定量测定作为筛查试验在泌尿系统疾病的识别中具有潜在的省力和诊断优势。