How to read the urine routine report? Ma Junlong, deputy director of the laboratory department of the PLA General Hospital, and Cong Yulong, chief physician, have a routine urine analysis, which we often do. Most hospitals use urine analyzers for testing. At present, there are 10,1or 12 items for testing, and the report format is not uniform, including "+"(positive) and "-"(negative), and there are numbers, and the units for testing items are different. How to read the urine test report? Urine routine items can be roughly divided into four categories: nephropathy, diabetes, urinary infection and other diseases. Nephropathy items include pH, specific gravity (SG), occult blood or red blood cells (BLD, ERY), protein (PRO) and color (COL). The normal reference values are: 4.6 ~ 8.0,1.005 ~1.030, positive, negative, light yellow to dark yellow. The changes of these indexes may indicate renal function damage. The items of diabetes include pH, protein, specific gravity, sugar (GLU) and ketone body (KET). The detection of these indexes is helpful to diagnose related complications and whether some organs of the body are damaged, such as ketonemia. Under normal circumstances, urine sugar and ketone bodies are negative. Urinary infection items include white blood cells (WBC), occult blood or red blood cells, nitrite (NIT), color and turbidity (TUR). When the urinary system is infected by bacteria, white blood cells and red blood cells often appear in the urine, the color or turbidity of the urine also changes, and nitrite is sometimes positive. Chemical detection of urinary white blood cells and occult blood or red blood cells only plays a screening role, and the clinical diagnosis is based on the results of microscopic examination. Other diseases are mainly pH, specific gravity, bilirubin (BIL), URO, color and other indicators. Bilirubin and urobilinogen reflect the ability and quantity of liver to metabolize heme. Under normal circumstances, urinary bilirubin is negative and urobilinogen is weakly positive. When the above indicators increase, it often suggests jaundice, and the urine color is yellow-green. There are "+"or "++"or numbers behind some items in the urine routine analysis test sheet, indicating different degrees, which is called a positive result in medicine; On the contrary, "-"is called a negative result. When reading the report, it is necessary to analyze the report objectively, because there are many interfering factors that affect the accuracy of the test results, such as diet factors and some interfering substances in urine. Please don't be too nervous and worried when the urine routine examination is abnormal; Similarly, don't be blindly optimistic when there are test results that are inconsistent with clinical manifestations. We must cooperate with clinicians for further examination and analysis, so as not to delay the diagnosis of the disease. How to read the urine routine examination report? Routine urine examination is an important item of health examination, which can not only reflect urinary system diseases, but also be of great significance for screening diabetes, jaundice hepatitis, biliary obstruction and other diseases. 1.Urine protein (PR0) Normal urine routine examination generally has no protein or only a trace amount. Increased and persistent urinary protein is more common in kidney diseases. However, fever, strenuous exercise and pregnancy will occasionally cause urinary protein. Therefore, it is necessary to follow up and observe the reasons for protein in urine. 2. The positive urine glucose (GLU) should be combined with clinical analysis, which may be diabetes or renal diabetes caused by the decrease of renal glucose threshold. The diagnosis should be made in combination with blood glucose test and related examination results. Because vitamin C and aspirin in urine can affect the results of urine sugar, vitamin C and aspirin should be stopped 24 hours before urine sugar check. 3. Urine red blood cells (RBC) Under each high-power microscope field of vision, there are more than 5 urine red blood cells, which is called microscopic hematuria; When there are a lot of red blood cells, it is called "gross hematuria", which can be seen in inflammation, infection, stones, tumors, etc. of the urinary system. We should pay more attention to it and go to the urology department for further examination immediately to clarify the location and cause of hematuria. 4. Urine white blood cells (WBC) Under each high-power microscope field of vision, there are more than 5 white blood cells in urine, which is called leukouria. When there are a large number of white blood cells, it is called pyuria, which means urinary tract infections, such as pyelonephritis, cystitis and urethritis. 5. Urine epithelial cells (SPC) There are a few epithelial cells in urine, which have little clinical significance; When a large number of cases appear, if we can eliminate the pollution of vaginal secretions, we must consider the existence of urinary system inflammation. At this time, if the morphological examination of urinary epithelial cells is added, the source of epithelial cells can be determined 6. Urinary casts (KLG), especially granular casts and cell casts, are signs of renal parenchymal lesions. 7. The urine occult blood (ERY) is normal and the urine occult blood test is negative. Those with positive urine occult blood and protein at the same time should first consider renal diseases and hemorrhagic diseases, and further renal function examination can be done; If urine protein is negative, you should go to the relevant specialist to find out the location and nature of bleeding. It is generally believed that the occult blood is not obvious because the red blood cells are not destroyed. 8. Urogenin (UBG), urinary bilirubin (BIL) Urogenin and urinary bilirubin are positive, which indicates the existence of jaundice, which is helpful for the diagnosis and differential diagnosis of jaundice. 9. Urinary nitrite (NIT) Urinary nitrite is mainly used for screening test of urinary tract infection. Nitrite is negative in fresh urine, and it can be false positive if the specimen is left for too long or bacteria grow and multiply. Why are the test results of the two hospitals different? Dr. Zhang Guohua, from the Laboratory Department of the First Hospital of Peking University, some people always hope to make a comprehensive judgment on the test results of multiple medical units to determine whether they are healthy or not. However, sometimes it happens that the laboratory tests in one hospital are normal, but they are abnormal in another hospital. So, why is this happening? There are many reasons. First of all, the most common reason is that the medical examiner did not read the "Instructions for Physical Examination" carefully and took the samples improperly, so that the samples tested by the same person twice were actually different. For example, fasting before blood drawing has a great influence on the determination results (such as blood sugar, blood lipid, etc.); Whether it is in a quiet state before blood drawing, because some items, such as transaminase, will rise after strenuous exercise; Whether the urine taken is morning urine or not, because the first urine in the morning is quite different from the usual random urine test results. Secondly, the physical condition of the medical examiner is inconsistent during the two physical examinations. For example, whether the medical examiner has taken drugs, some drugs will affect the measurement items (such as transaminase, creatinine, etc.), or whether the female medical examiner is in menstrual period. In addition, it is also possible that the two hospitals have different determination methods and different instruments, resulting in different results. Another possibility is that medical workers have a weak sense of responsibility, and they have made a mistake in specimens. If the test results of the two hospitals are inconsistent, the medical examiner need not panic, and can ask the medical staff to make a reasonable explanation, and take the samples correctly under the guidance of the medical staff, cooperate with them to find out the reasons and show the true nature of their physical condition. 1. Introduction to blood routine Blood routine includes hemoglobin determination, red blood cell count, white blood cell count and white blood cell classification count. A. Hemoglobin (Hb):120 ~160g/L for normal males,10 ~150g/L for females and 170-200g/L for newborns. * increase: polycythemia vera, severe dehydration, pulmonary heart disease, congenital heart disease, residents in mountainous areas, severe burns, shock, etc. decrease: anemia, bleeding * B. Red blood cell (RBC) count: 4-5.5 million /μL for normal men, 3.5-5 million /μL for women and 6-7 million/μ L for newborns. * increase: polycythemia vera, severe dehydration, pulmonary heart disease, congenital heart disease, residents in mountainous areas, severe burns, shock, etc. decrease: anemia, bleeding * C. White blood cell (WBC) count: 4000 ~10000/μ l for normal adults and15000/μ l for newborns. * Elevated: all kinds of cell infections, inflammation and severe burns. Leukemia should be excluded when it is obviously elevated. Decreased: leukopenia, hypersplenism, hematopoietic dysfunction, radiation, drugs, chemical toxins and other causes of bone marrow suppression, malaria, typhoid fever, viral infection, paratyphoid fever. * Leukemia is common in inflammatory infections, bleeding, poisoning, leukemia and so on. It can reduce viral infectious diseases such as influenza and measles, severe septicemia, drugs or radiation, and some blood diseases. * D. White blood cell classification count (DC, by ratio): White blood cells are divided into 5 categories. One is neutrophil (Gran), which is normally 0.50 ~ 0.70, and the reason for the increase or decrease is the same as the white blood cell count; * Increased: bacterial infection, inflammation; Decrease: viral infection * Second, lymphocytes (Lym), normally 0.20 ~ 0.40, increase is often seen in neutropenia, tuberculosis, whooping cough, etc. Its reduction is common in neutropenia; * Increased: whooping cough, infectious mononucleosis, viral infection, acute infectious lymphocytosis, lymphocytic leukemia; Decrease: Immunodeficiency * 3 is eosinophil, which is 0.005 ~ 0.05 normally, and is more common in parasitic diseases, allergic diseases and some skin diseases; * Elevated: chronic myeloid leukemia and chronic hemolytic anemia. * Fourth, basophils, normal 0 ~ 0.01,with little clinical significance; Fifth, monocytes, which are normally 0.03 ~ 0.08, are found in the recovery period of acute infectious diseases when they increase. * Elevated: tuberculosis, typhoid fever, malaria, monocytic leukemia. * E. Platelet (PLT): normal: (100-300)%* Elevated: primary thrombocytosis, polycythemia vera, chronic leukemia, myelofibrosis, symptomatic thrombocytosis, infection, inflammation, malignant tumor. Decrease after exercise: primary thrombocytopenic purpura, disseminated lupus erythematosus, drug-allergic thrombocytopenia, disseminated intravascular coagulation, increased platelet destruction, decreased platelet production, aplastic anemia, bone marrow hematopoietic dysfunction, drug-induced bone marrow suppression, hypersplenism. * F. Erythrocyte sedimentation rate: 0-15 mm/h for male and 0-/5 mm/h for female by westergren method. Iahinhkob method is 0-8 mm/h for males and 0-12 mm/h for females. * Acceleration: acute inflammation, connective tissue disease, severe anemia, malignant tumor, tuberculosis. Slow down: polycythemia, dehydration. G. Reticulocyte count: normal: (00.5- 1.5)%* Increase: hemolytic anemia, massive hemorrhage, iron deficiency anemia, and vitamin B/kloc-for malignant anemia. Leukemia. *2. Children's blood routine The most common disease of a baby may even be a cold. If it is not treated in time, it will start to burn. At this time, take the baby to the hospital and the doctor will let the blood be checked beforehand. Why do you need a blood test? Because when people are sick, the number of various cells in the blood will change. Such as anemia, the number of red blood cells or hemoglobin content will change; When inflammation occurs in the body, the number of white blood cells will increase. Mainly depends on which indicators. There are often a long list of laboratory items on the blood routine test list, but some of them are more professional items, and we don't have to go into them. Looking at the blood routine test list, we need to focus on three aspects: red blood cell count (RBC) and hemoglobin determination (HGB). The first item of the blood routine test list is the examination of red blood cell count. We know that the main function of red blood cells is to deliver oxygen to various tissues and organs of the whole body and excrete carbon dioxide produced in the body, and to accomplish this main function mainly depends on a protein in red blood cells, which is hemoglobin (Hb). Generally speaking, the ratio between the number of red blood cells and hemoglobin content is relatively fixed. However, in the case of anemia, the ratio between them will change. For example, in the case of hypochromic anemia, the hemoglobin content will decrease obviously, and the ratio of red blood cells to hemoglobin will increase. Therefore, when looking at the test sheet, we must first pay attention to the values of these two items. White blood cell count (WBC) and white blood cell classification count (DC) White blood cells in blood include neutrophils, eosinophils, basophils and lymphocytes. The white blood cell count (WBC) in the laboratory sheet refers to the total number of white blood cells in the blood, while the classified count refers to the percentage of various white blood cells. Because of the different physiological functions of various white blood cells, the number of different types of white blood cells can be changed under different pathological conditions. Generally speaking, we just need to know the white blood cell count, the classification of neutrophils (N) and lymphocytes (L), because in our daily life, doctors judge whether there is infection in the body according to the number of white blood cells, and then judge what kind of infection and what kind of drugs should be used according to the classification of white blood cells. Generally speaking, if the number of neutrophils increases, it is a bacterial infection, and the number of lymphocytes increases, it is a viral infection. As we all know, platelet count (PLT) is the main function of blood coagulation. Without it, we may be in danger of life due to a small wound. Generally speaking, the count of platelets is the third key point that we should pay attention to when observing the test sheet. If platelets decrease, the baby may have blood coagulation problems. Average normal value (mean) of blood cell components of babies of all ages Chinese abbreviationNo. 1 day 2 ~ 7, week 2, 3 months and 6 months1~ 2 years old, 4 ~ 5 years old red blood cells (×1012/l) RBC 5.7 ~ 6.45.2. ) HGB180 ~195163 ~18011123. \) WBC201512-1218 neutrophil n% 0.650.400.350.30.310.3660. (× 109/L\\)PLT 150-250 150-250 150-250250250-300250-300250-300