尿透明质酸检测对膀胱移行细胞癌的诊断意义

目的 :探讨尿液透明质酸 (HA)含量检测在膀胱移行细胞癌诊断中的意义并研究放射免疫 (放免 )方法代替酶联免疫吸附 (ELISA)方法检测尿液中HA含量的可能性。方法 :同时使用ELISA和放免两种方法对 49例膀胱移行细胞癌、1 2例良性膀胱肿瘤、30例良性前列腺增生 (BPH)和泌尿系结石以及 2 0例正常人尿液中HA含量进行检测 ,并将其结果与尿脱落细胞学检查结果进行比较。结果 :ELISA方法和放免方法测得各组尿液HA值结果相近 (P >0 .0 5)。以放免方法所得结果进行分析 ,膀胱移行细胞癌组尿液HA含量是对照组的 2～ 4倍 ,差异有极显著性意义 (P <0 .0 1 )。以对照组尿液HA水平上限 1 37.5μg/ g作为阳性界值时 ,尿液HA含量检测诊断膀胱移行细胞癌的敏感性为 91 .8% ,特异性为 91 .9% ,与尿脱落细胞学相比 (敏感性为 48.9%、特异性为95 .2 % ) ,敏感性差异有极显著意义 (P <0 .0 1 ) ,特异性差异无显著性意义 (P >0 .0 5)。结论 :尿液HA含量检测是一种简单、无创、价廉、结果客观、敏感性和特异性均较高的诊断膀胱移行细胞癌的方法 ;价格更为低廉的放免法可代替ELISA方法进行尿液HA含量的检测。     

The method of choice for the determination of 2,5-hexanedione as an indicator of occupational exposure to n-hexane

Summary To identify the method of choice for analysis of urine for 2,5-hexanedione (2,5-HD) as an indicator of occupational exposure to n-hexane, the end-of-shift urine samples of 36 n-hexane exposed male workers and 30 non-exposed male workers were analyzed for 2,5-HD under three conditions of hydrolysis, i.e. enzymic hydrolysis at pH 4.8, acid hydrolysis at pH 0.5, and without hydrolysis. The 2,5-HD concentrations thus determined were examined for correlation with 8-h, time-weighted average exposure concentrations of n-hexane measured by diffusive sampling. The regression analysis showed that the 2,5-HD concentrations without any hydrolysis correlated best with the intensity of exposure to n-hexane. No 2,5-HD was detected in the urine of the non-exposed subjects under the analytical conditions with no hydrolysis. Thus, the analysis without hydrolysis was considered to be the method of choice from the viewpoint of simplicity in analytical procedures, sensitive separation of the exposed from the non-exposed, and quantitative increase in the amount of 2,5-HD after n-hexane exposure.A part of this work was presented at the 63rd Annual Meeting of Japan Association of Industrial Health, held in Kumamoto, Japan, on 3rd–6th April, 1990     

A time-saving procedure for the determination of total trichloro-compounds in human urine samples

Summary A modification (Tanaka and Ikeda, 1968) of the original method of Seto and Schultze (1956) has been further improved, by utilizing the heat in a boiling water bath for both the oxidation and colour development. As a result the determination of total trichloro-compounds in human urine could be carried out within 1 hr.This work was supported in part by a research grant from the Fujiwara Memorial Foundation.     

肾脏损害检测指标在肝豆状核变性临床诊断中的应用价值

目的比较肝豆状核变性(HLD)患者的尿常规、血尿酸及肾脏超声等肾损害检测指标与非HLD肝病患者、非HLD锥体外系疾病患者之间的差异,筛选出对HLD早期诊断有意义的诊断指标。方法 185例首次入院的HLD患者(A组)、54例非HLD肝脏疾病的患者(B组)和18例非HLD其他锥体外系疾病患者(C组)为研究对象,收集其尿常规、血尿酸及肾脏超声等检测结果资料,比较各组之间的差异。结果尿常规、血尿酸及肾脏超声检查在A、B、C三组组间差异有统计学意义(χ2=10.269,P=0.006;F=61.235,P=0.000;χ2=14.869,P=0.001);A组与C组在尿常规、血尿酸之间的差异有统计学意义(χ2=9.264,P=0.002;F=52.363,P=0.000);A组与B组在血尿酸及肾脏超声检查之间的差异有统计学意义(χ2=1.143,P=0.285;F=43.213,P=0.000)。结论在有锥体外系症状的患者中出现尿常规的异常和血尿酸减低,或在不明原因的肝病患者中出现血尿酸减低及肾脏超声的异常改变,应高度怀疑HLD的可能,建议进一步做铜代谢检查以明确诊断。     

Pediatric reference values for urine particle quantification by using automated flow cytometer: Results of a multicenter study of Italian urinalysis group

Objectives

The purpose of this Italian multicenter study was to define pediatric upper reference values for urine particle quantification by using automated flow cytometry.

Design and methods

Four hospital-based clinical laboratories participated in this multicenter investigation, which included a total study population of 161 Italian children aged from 1 to 12 years. Two laboratories used Sysmex UF-100 and analyzed 86 children, whereas the other two used Sysmex UF-1000i and analyzed 75 subjects. Particle quantification included the analysis of white blood cells (WBC), red blood cells (RBC), squamous epithelial cells (EC), transitional epithelial cells (TC), casts (CAST) and bacteria (BACT).

Results

The upper reference values in subjects tested with the Sysmex UF-100 were 9.7 WBC/μL, 10.1 RBC/μL, 7.5 EC/μL, 2.5 TC/μL, 0.7 CAST/μL and 3090 BACT/μL, whereas the upper reference values in subjects tested with the Sysmex UF-1000i were 10.5 WBC/μL, 8.3 RBC/μL, 7.2 EC/μL, 2.9 TC/μL, 0.7 CAST/μL and 48 BACT/μL. No statistically significant differences between genders were found in the value distribution of any of the parameters tested. Similarly, no statistically significant differences were observed between the two urine analyzers, except for BACT.

Conclusions

Automated analysis of urine particles appears a suitable means to optimize the workflow of routine urinalysis of children specimens. The upper reference limits for pediatric subjects obtained in this study were comparable to those previously reported in the literature, with no significant differences between genders and analyzers.     

尿液B型钠尿肽水平在慢性心力衰竭诊断中的意义

目的 探讨尿液BNP水平对慢性心力衰竭的诊断价值。方法采用微粒酶免疫测定法检测83例慢性心力衰竭患者（NYHAⅠ ～Ⅳ级）和30名健康对照者的尿液和血浆BNP浓度,同时采用NYHA标准对心功能进行分级,并用超声心动图检查评定患者心功能。结果慢性心力衰竭组尿液BNP水平为[90.0(38.3～209.5)]ng/L,血浆BNP水平为[680.0(289.7 ～ 1543.5)]ng/L,明显高于健康对照组的[17.0（13.0 ～33.0）]ng/L和[84.5(56.0～158.0)]ng/L,差异均有统计学意义（U值分别为207.5、71.0,P均＜0.01）。随心功能NYHA分级的增高,尿液BNP水平逐渐升高。尿液BNP水平与血浆BNP水平呈正相关(r=0.842,P＜0.01),与NYHA分级呈正相关(r =0.742,P＜0.01),与LVEF呈负相关（r=-0.801,P＜0.01）。LVEF＜ 40％患者的尿液BNP水平为[143.0(85.0 ～258.0)]ng/L,LVEF≥40％患者的尿液BNP水平为[31.5(17.3～38.8)]ng/L,差异有统计学意义(U=80.0,P＜0.01)。以36.5 ng/L为临界值时,尿液BNP诊断慢性心力衰竭的敏感度为84％,特异度为80％。结论 尿液BNP对慢性心力衰竭的诊断有重要意义,与血浆BNP具有相似的诊断价值。     

尿液有形成分检查及镜检筛选标准的制定

尿液有形成分检查对于泌尿系统疾病的诊断、鉴别诊断及预后判断具有重要临床价值,为了解尿液有形成分分析方法学的标准化及规范化进程,本文阐述了自动化设备用于尿有形成分检查的"利"与"弊",提出了制定镜检筛选标准应遵循的准则.

Abstract：

Urine sediment analysis is of importance for the diagnosis, differential diagnosis and prognosis in urinary system diseases.To understand the standardization of sediment analysis and its development, This article analyzes the advantage and disadvantage of automated instrument used in urine sediment analysis, and then developes the criteria for microscopy review following automated urinalysis.     

尿干化学与流式细胞术联合用于尿液有形成分镜检筛选的研究与应用

目的 制定针对UF-1000i尿液分析流水线(由UF-1000i尿流式分析仪和AX-4030尿干化学分析仪组成)自动化检测结果的尿液镜检复检规则.方法 收集2009年9月至2010年2月解放军总医院尿液常规标本共2 839份.首先利用UF-1000i尿液分析流水线对2 839份尿液标本进行有形成分分析(包括RBC、WB...     

尿液有形成分镜检与自动化检测方法学利弊和互补分析

结合当前国内外尿液分析的发展现状和目前国内常规检验工作忽视尿有形成分检查的错误倾向,笔者参考国家(际)标准、文献及本人的临床实践、科研成果,阐述了尿液有形成分检查的临床价值、标准检验流程,评论了应用各种仪器进行镜检筛选的优点与不足,并对如何加强我国尿液分析的质最管理提出了见解.     

焦炉工尿中1-羟基芘水平与早期遗传学效应的关系

目的 研究焦炉工尿中1-羟基芘水平与外周血淋巴细胞胞质分裂阻滞微核和彗星尾矩间的关系。方法 分别选取133名焦炉作业工人和28名非职业暴露人员,使用碱水解-高效液相色谱法测定尿中1-羟基芘浓度作为个体多环芳烃暴露内剂量,分别应用彗星试验和胞质分裂阻滞微核法评价了研究对象外周血淋巴细胞DNA和染色体损伤,使用调查表收集职业暴露史、年龄、性别、吸烟和饮酒状况等信息。结果 调整了年龄、性别、吸烟和饮酒状况后,尿中1-羟基芘浓度与外周血淋巴细胞微核细胞率和彗星尾矩均存在良好的相关关系。进一步按尿中1-羟基芘水平将研究对象分成0．30～2．44(54人)、2．45～7．09(53人)和7．10～33．10μmol／mol肌酐组(54人)3个内剂量组,3组个体尿中1-羟基芘的几何均值分别为1．14、4．32和12．49μmol／mol肌酐。使用多元非参数协方差分析校正了不同内剂量组个体的年龄、性别、吸烟和饮酒状况后,7．10～33．10μmol／mol肌酐组的彗星尾矩(中位数3．67)显著性高于2．45～7．09和0．30～2．44μmol／mol肌酐组(中位数分别为1．68和1．12),但后2组之间差异无显著性;2．45～7．09和7．10～33．10μmol／mol肌酐组微核率的中位数分别为8．00‰和7．50‰,2组间的差异无显著性,但均显著高于0．30～2．44μmol／mol肌酐组的6．00‰。结论 外周血淋巴细胞的彗星尾矩较胞质分裂阻滞微核能更好地反映多环芳烃暴露导致的早期遗传学效应。