尿液自动分析、尿沉渣及尿常规镜检对尿中有形成份的对比分析

目的：观察尿常规、尿自动分析仪和尿沉渣对100例尿中有形成份检测的敏感性。方法：100例病人的尿标本分别进行干化学分析，尿沉渣镜检和尿常规镜检，根据检查结果与临床诊断作对比，了解其诊断的符合率。结果：三种方法红细胞，白细胞，管型检测均有差异（P＜0．05），其中：干化学法和尿沉渣镜检法对RBC的检出率明显高于常规法（P＜0．001），而干化学法与尿沉渣镜检法对RBC的检出无显著性差异（P＞0．05），尿沉渣镜检对WBC的检出率高于常规镜检及干化学法（P＜0．05），而常规镜检对WBC的检出率与干化学法无显著性差异（P＞0．05），尿沉渣镜检和尿常规镜检对管型的检出有显著性差异（P＜0．05），以尿沉渣的检出率为高，结论：尿沉渣检镜是三种方法中对尿有形成份检出最好的一种方法。     

Sialic acid concentrations in the urine of men with and without renal stones

Summary It has been suggested that urinary sialidase may play a role in the formation of renal stones. The present study was therefore undertaken to compare spectrophotometrically the different types of sialic acid concentrations and sialidase activities in fresh first morning urine specimens of men (21–65 years) with (13) and without (9) calcium oxalate renal stones. Although the free urinary sialic acid concentrations of the two groups of men were statistically about the same (P=0.0614), the total (P=0.003) and bound (P=0.0012) urinary sialic acid concentrations differed significantly. Both the total and bound sialic acid concentrations were lower in the urine specimens of the stone patients than in their healthy counterparts. This decrease in urinary sialic acid concentrations was firstly thought to be the result of elevated breakdown enzymes of sialic acid, which would favour the production of pyruvate. However, spectrophotometric determinations of the endogenous pyruvate concentrations of the two types of urine specimens did not differ significantly (P=0.0708). Secondly, the decrease in total urinary total sialic acid concentration of stone patients, could be attributed to less sialic acid synthesis or less renal excretion. Therefore, the same experiments were repeated using serum of 13 patients and 9 healthy men. Conversely, the total (P=0.4425) and bound (P=0.2850) serum sialic acid concentrations were found to be similar in the two types of subjects. However, the free serum sialic acid concentration of stone patients was significantly lower than in the healthy subjects (P=0.0062). This phenomenon is also reflected in the average ratio for serum free: bound sialic acid in healthy and stone patients, 1:7.9 and 1:18.7 respectively (P=0.0009). The lower free serum sialic acid concentration may lead to lower renal excretions of sialic acid. This may explain the decrease in total urinary sialic acid concentration in stone patients. The lower bound urinary sialic acid concentrations in patients was also reflected in the urinary free: bound sialic acid ratio for healthy (1:2.3) and stone patients (1:1.3). The difference between these two groups of men was highly significant (P=0.0001). This phenomenon might be explained by the urinary sialidase activities, which was spectrophotometrically determined at 334 nm at 37°C of 11 patients with stones and 17 healthy men. The ages of both groups of men were the same (P=0.326). An increase in urinary sialidase activity was observed with the stone patients (P=0.00001) when compared to specimens of healthy men. This might explain the decrease in urinary bound sialic acid concentration of the stone group. It seems from these results that the urinary concentration of sialic acid and the activity of urinary sialidase, may play a role in the pathogenesis of the multifactorial disease, urolithiasis.     

Effects of different doses of alkaline citrate on urine composition and crystallization of calcium oxalate

Summary Prophylactic treatment with alkaline citrate in patients with recurrent calcium oxalate (CaOx) stone disease results in reduced CaOx supersaturation and increased urinary citrate. The effects of a single evening dose were compared with those of two and three daily doses in six recurrent CaOx stone formers with hypercalciuria, hypocitraturia or raised calcium/citrate quotients. While on a standardized hospital diet the patients were given 7.5 g (28 mmol) of sodium potassium citrate (URALYT-U) in one, two, and three doses. Fractional urine collections during 24 hours were analyzed for pH, composition, and crystallization risk (CR). All dosage regimens had favourable effects on urinary calcium, citrate, calcium/citrate quotients, and CaOx-CR. The most sustained effect was recorded with three divided doses. Single evening doses resulted in the most pronounced effects between 22.00–06.00 h, thereby counteracting the increased risk of CaOx crystallization during that period. In terms of 24 h urine composition the best effect was recorded with alkaline citrate administered three times daily, but because of the favourable response by a single evening dose between 22.00–06.00 h the assumption was made that this dosage regimen might be sufficient to reduce the risk of CaOx crystallization and stone formation. However, the validity of such an assumption can only be established by long-term clinical studies.     

尿微卫星不稳定性研究对膀胱肿瘤诊断的探讨

目的：探讨尿微卫星不稳定性改变(MSI)与膀胱移行细胞癌(TCC)临床病理特征的关系及其在早期诊断中的价值。方法：选择36例TCC患者5个微卫星位点,应用聚合酶链反应-变性聚丙烯酰胺凝胶银染法分析尿微卫星的改变。结果：36例中有22例(61．11%)出现微卫星不稳定性改变(LOH/MSI),并与肿瘤的分期、分级无关(P＞0．05)；尿脱落细胞学检查的阳性率为22．22%(8/36),两者相比差异有统计学意义(P＜0．05)。结论：尿沉渣微卫星不稳定性分析对膀胱癌的早期诊断有一定的意义,是尿脱落细胞学检查的重要补充。所选微卫星位点为本地区膀胱癌的进一步研究奠定了基础。     

运动对体内代谢产物排出量的影响

选择年龄15～18岁的体育学校学生23名(男14、女9),随机分为三个不同的运动组进行跑台训练。结果显示:运动可导致尿乳酸,尿蛋白、尿糖和尿素氮含量增加。无氧训练时尿乳酸的增加尤为明显;尿蛋白的增多与尿液乳酸含量呈正相关;尿素氮水平的升高则以有氧耐力运动时为甚。     

尿αl微球蛋白与微量白蛋白联合检测在高血压病肾损伤早期诊断中的临床价值

在原发性高血压中，因肾功能受损导致蛋白尿甚至血清尿素氮、肌酐增高并依赖透析的患者在临床非常多见，然而一旦出现BUN、Cr增高及肾功能不全时，往往已经对临床治疗造成困难，于是，早发现、早治疗，对控制高血压肾病的发生与发展是十分必要的。     

尿核基蛋白22检测在膀胱癌诊断中的价值

目的:探讨尿核基蛋白22(NMP22)在膀胱移行细胞癌诊断中的临床价值。方法:采用ELISA法定量分析16例膀胱移行上皮癌(TCC)、14例TCC术后随访患者和12例泌尿系良性疾病患者的尿NMP22含量,并同时行尿脱落细胞学检查。设定NMP22的临界值为10U/ml。结果:16例膀胱移行癌患者、14例膀胱癌术后随访患者和12例泌尿系良性疾病患者的尿NMP22中位值分别为31.65、5.41和6.74U/ml,前者与后两者均有统计学差异(P<0.001)。以10U/ml为界值,尿NMP22诊断膀胱癌的敏感性为93.7%,特异性为69.2%,阴性预测值为94.7%,准确性为78.6%。同期尿细胞学的敏感性为31.3%,特异性100%,阴性预测值为70.2%。结论:与脱落细胞学比较,尿NMP22测定有更高的敏感性,是一种较理想的早期膀胱移行细胞癌诊断指标,对预后判断亦有价值。     

Renal excretion of endothelin in children

Endothelin (ET) is a peptide with profound vasoconstrictive potential. First isolated from porcine endothelial cell supernatant, it is produced also by smooth muscle, epithelial and circulating cells. Besides vasoconstriction, a wide spectrum of biological activities of ET (via activation of membrane receptors) has been described. These include regulation of other hormones and neurotransmitters, cellular growth and proliferation, bronchoconstriction, and, in the kidney, natriuresis and water diuresis. ET exerts its effects mainly in an autocrine and paracrine fashion. A high concentration of ET is found in urine, compared with plasma originating mainly from the kidney itself. In this review we focus on the role of urinary excretion of ET in children. ET excretion was determined under different physiological and pathological conditions. In premature infants and newborns, the daily excretion of ET (corrected for body surface) was higher than in older children; it was constant, and comparable to the values in healthy adults after the age of 2 years. Renal ET excretion correlated positively with urine flow in both healthy and sick children. Conditions with tubular and/or collecting duct cell damage, such as severe hypoxia, hemolytic-uremic syndrome, renal transplantation, diabetes mellitus, chronic renal failure, and contrast media cytotoxicity were characterized by elevated urinary excretion of ET. In conclusion, the renal excretion of ET is influenced by several factors, probably reflecting the intrarenal ET production. ET has a low specificity with regard to renal injury. Received May 7, 1996; received in revised form January 14, 1997; accepted January 17, 1997     

儿童边缘性锌缺乏症综合判断的研究

对沈阳市某幼儿园９９例３～６岁锌缺乏儿童的营养调查和生物样品（血液、尿液和毛发）的分析发现：同对照组儿童相比，锌缺乏儿童除Ｆｅ、维生素Ａ外，其他主要营养素的摄入明显不足；缺锌儿童的发锌、ＲＢＣ锌水平、血清ＡＬＰ活性、尿锌／尿肌酐比值均明显低于对照组。经补锌治疗后血浆锌水平、血清ＡＬＰ活性、尿锌／尿肌酐比值显著升高。应用临床诊断实验的评价方法分析发现结合血浆锌水平，联合使用发锌，血清ＡＬＰ和尿锌／尿肌酐比值３项指标可以准确判断儿童边缘性锌缺乏，这时并联的灵敏度为９６．１８％，串联的特异度可高达到１００％（血清ＡＬＰ活性＜１０４ＩＵ／Ｌ，同时发锌含量＜１１０ｐｐｍ．尿锌／尿肌酐比值＜０．３μｇ／ｇ）。