Drapkina O M, Samorodskaya I V, Larina V N
National Research Center for Therapy and Preventive Medicine.
Pirogov Russian National Research Medical University.
Ter Arkh. 2021 Jan 10;93(1):71-78. doi: 10.26442/00403660.2021.01.200596.
The review article presents data on: a) definition of microhematuria and diagnosis; b) prevalence estimation and causes of the asymptomatic microscopic hematuria; c) diagnostic approaches for the first time identified of microhematuria; d) follow-up monitoring of patients with asymptomatic hematuria; e) feasibility of medical screening for microhematuria. The analysis includes recommendations of Russian and foreign urological associations, the results of cohort and observational studies, previous study reviews. The identification of 3 or more red blood cells during microscopic examination should be considered microhematuria. There is no uniform examination algorithm for all patients. The basic principle is an individual diagnostic tactic, taking into account the anamnesis, age, concomitant diseases and risk factors. The purpose of a comprehensive examination is to exclude life-threatening conditions (malignant neoplasms and/or glomerular kidney damage). In some cases, after research, the cause of microhematuria remains unclear and monitoring is required. Routine screening of the population in order to detect microhematuria is currently not justified.
a) 微血尿的定义与诊断;b) 无症状镜下血尿的患病率估计及病因;c) 首次发现微血尿的诊断方法;d) 无症状血尿患者的随访监测;e) 微血尿医学筛查的可行性。分析内容包括俄罗斯和国外泌尿外科学会的建议、队列研究和观察性研究的结果以及以往的研究综述。显微镜检查时发现3个或更多红细胞应被视为微血尿。目前尚无适用于所有患者的统一检查算法。基本原则是采取个体化诊断策略,同时考虑病史、年龄、伴发疾病和危险因素。全面检查的目的是排除危及生命的疾病(恶性肿瘤和/或肾小球肾损伤)。在某些情况下,经过检查后微血尿的病因仍不明确,需要进行监测。目前对人群进行常规筛查以检测微血尿是不合理的。