As everyone pays more and more attention to health, many people have their own medical reports. This report includes many routine inspection items, among which urine routine, blood routine and stool routine are the most basic inspection items, which are called the "three routines".
Urine routine is the most common examination item. It can not only reflect the function of the kidneys, but also an index to evaluate the body's metabolism. We can't help but wonder: Since urine routine is so important, but we are not doctors, how can we understand urine routine? How can I know if the daily urination is normal? What do the symbols in the urine routine test mean? Don't worry, today we will interpret the urine routine examination in detail to ensure that you can understand the urine routine by yourself in the future.
1. How to collect urine correctly?
Before doing an examination, you must first understand the correct method of collecting urine. If the method is not correct, the results of the examination may have errors, which may mislead the clinician's diagnosis. Generally, clean and dry containers are used for collection, and the most common is a disposable urine cup. Avoid contaminating the urine cup and urine during collection. The urine should be about 10-30ml during the examination. Do not drink a lot of water, coffee, strong tea, etc. before the examination.
Submit for inspection within the specified time. The collected urine should be sent for inspection within half an hour, and no more than 1 hour at the latest.
Collect morning urine. Urine collection is usually the first urine in the morning. Sometimes it is difficult to do. It is acceptable to urinate at will.
Collect midstream urine. When collecting, keep the urine in the middle section. Don't collect the urine at the beginning or the end. Of course, sometimes for the purpose of diagnosis, the initial urine and the last urine are collected.
Avoid menstrual periods. Clean the vulva before collection. For men with too long foreskin, it is best to clean the urethral opening and turn up the foreskin when collecting urine; female compatriots should avoid the menstrual period when urine is collected, so as to prevent the mixing of vaginal secretions.
2. What do the symbols on the checklist mean?
Nowadays, hospitals use automated analysis instruments for testing, so many hospitals can print out routine urine tests by themselves. When we get the report form, there are many symbols on it, for example, ↑ means the indicator is increasing, and ↓ means the indicator is decreasing. The +,-and on the test sheet represent positive, negative and weakly positive respectively. The number of + represents a change in quantity. For example, +, ++, and +++ indicate that the degree of positive is gradually increasing.
3. How to understand urine routine report?
Urine routine checklists generally include urine color, specific gravity, pH value, protein, red blood cells, white blood cells, urobilinogen, bilirubin, glucose, ketone bodies, nitrite and vitamin C.
1) What can color and pH suggest?
The color of normal urine should be clear and light yellow. When drinking a lot of water, the urine will be colorless and transparent like boiled water. If you drink less water, your urine will be as yellow as beer.
If the urine appears red, soy sauce, milky white, etc., it must be taken seriously. There are many diseases that can cause abnormal urine color, such as tumors, liver diseases, urinary tract infections, and chyluria. Especially if the middle-aged and elderly people have painless gross hematuria, the tumor disease must be ruled out first, even if it only appears once, it should not be taken lightly.
The pH value of urine is about 6.5, and the pH value changes with the composition of the daily diet, and the fluctuation range is between 4.5 and 8.0. Urine becomes acidic when eating more meat, and alkaline when eating fruits and vegetables. Infections, gout, and drug metabolism all affect the pH of urine.
2) Diabetics should pay special attention to ketone bodies and glucose
Ketone body: normal is "-" negative. Diabetes patients need to pay special attention to this item. If the blood sugar control is not good, this item will be positive "+". It should be noted that if the specimen submitted for inspection is not fresh, a "+" will appear, and a "+" will appear when the stomach is too hungry.
Glucose: This item is also an item that diabetic patients need to pay special attention to. Normally, it is "-" negative. + Means positive. The more +, the higher the glucose content in urine. The use of some drugs, such as aspirin, salicylic acid, streptomycin, etc. may present pseudodiabetes.
3) Two indicators that can indicate liver disease
Normal urobilinogen is "-" negative. If the item is reported as "+", it means it is positive, which is more common in liver diseases and blood diseases, such as hemolytic jaundice, acute hepatitis, fava bean disease, etc.
Bilirubin: normal is "-" negative. A positive "+" is abnormal, which is more common in liver and pancreatic diseases, such as liver cirrhosis and obstructive jaundice.
4) Why are red blood cells and white blood cells appearing in the urine?
Red blood cell
Refers to the number of red blood cells in the urine. During the urine routine examination, if there are more than 3 red blood cells in the urine, it is called hematuria. According to the severity, it can be divided into gross hematuria and microscopic hematuria. If the hematuria is red, blood samples or blood clots when observed with the naked eye, it is called gross hematuria. If it is invisible to the naked eye, it is called microscopic hematuria. There are many reasons for hematuria, the common ones are stones, infections, injuries, tumors, and immune diseases. We need to pay special attention to hematuria. If it occurs, we should find out the cause as soon as possible.
In addition, it is not necessarily hematuria if urine is red. Because the color of urine can be affected by food, medical procedures and drugs. For example, women stay urine during menstruation; hemorrhoids or bleeding near the urethra mixed in the urine; urethral intubation, cystoscopy or gynecological examination may be mistaken for a positive result. Taking rifampicin can make urine appear red.
White blood cells: Negative is normal. If "+" or the value exceeds the reference value, it indicates urinary tract infection. If the infection is more serious, "++" or "+++" will appear.
5) What if protein and nitrite appear in the urine?
Protein: This is what we often call urine protein, which is normally negative. If this item is positive "+", it indicates that there may be nephritis, nephropathy, and normal people may also be positive after strenuous exercise.
Nitrite: Negative is normal, and positive can be seen in urinary tract infections. If you eat too much vitamin C or nitrate-rich foods, false positives will occur.
6) Some other indicators
Specific gravity: the normal range is 1.015-1.025. When the body is dehydrated, the specific gravity of urine increases, and vice versa.
Vitamin C: It reflects the body's intake of vitamin C and is of no significance to the diagnosis of diseases.
In addition, there are some indicators such as casts: normal urine routine examinations generally do not see casts, and occasionally a few transparent casts can be seen. If there are red blood cell casts, granular casts, etc., it often indicates nephritis, nephrotic syndrome and other kidney disease. Epithelial cells: Nothing is normal. The normal value is 0 to a small amount, and the increase is seen in urinary tract infections.
5. Healthy "code" in pee
We normally need to excrete 1-2L of urine every day. If symptoms such as frequent urination, urgency, and incomplete urination occur, it may be caused by infection of the genitourinary system or bladder disease.
You should pay attention to the color and smell of your urine every time you urinate, because these are the "codes" given to us by the body. Many diseases can be detected early through this information. Normal urine will smell of ammonia due to the decomposition of urea. If you smell a rotten apple, it may be a sign of diabetes. If there is a lot of foam in the urine, it may be due to the high protein content in the urine, indicating that there may be kidney disease, high blood pressure, or diabetes.
A simple urine routine report hides so many mysteries. I believe that after reading these, everyone should be able to understand the urine routine report. If there is an abnormal situation, you should promptly ask the hospital for further examination. We should not only pay attention to the daily urination situation, but also defecate should not be ignored. In the next issue, we will bring you stool routines (if any) to teach you to understand the laboratory test sheet.