Bài giảng Phân tích nước tiểu, cặn lắng nước tiểu

PHÂN TÍCH NƯỚC TIỂU,
CẶN LẮNG NƯỚC TIỂU

TS. Nguyễn Hữu Tùng


I. Introduction
1. History and importance

+ Uroscopy


Urinalysis
Past
+ Physical properties

Modern
+ Physical properties
+ Chemical analysis
+ Microscopic examination of
urine sediment


❖Urine Formation

❖Urine Composition
❖Urine Volume

II. Microscopic Examination of Urine
Urinary sediment: insoluble materials present in
the urine
+ RBCs
+ WBCs
+ Epithelial cells
+ Casts
+ Bacteria, yeast
+ Parasite
+ Mucus
+ Spermatozoa
+ Crystals
+ Artifacts


1. Macroscopic Screening


2. Preparation and Examination of the Urine Sediment

2.1. General procedures
+ Specimen preparation
+ Specimen volume: 10-15 mL
+ Centrifugation: 5 mins and RCF of 400

+ Volume of sediment examined: 20 uL (0.02 mL)
+ Examination of the sediment: both low (10x) and high
(40x) power

+ Reporting of the microscopic examination

-

Protocol
Result:
Casts: low-power field and average of 10 fields
RBCs, WBCs: high-power field and average of 10 fields
Epithelial cells, crystals, and other elements: (+), (++), (+++), (++++)


2.2. Sediment Examination Techniques
2.2.1. Sediment Stains



Safranin O

O-Toluidine


2.2.2. Microscopy


2.2.3. Sediment Constituents
1. Red Blood Cells

Clinical significance:
-

Glomerular membrane or vascular injury within the
genitourinary

Hematuria: trauma, acute infection or inflammation, and
coagulation disorders



2.2.3. Sediment Constituents
2. White Blood Cells

Clinical significance:
+ Nomal urine: < 5 leukocytes
+ Pyuria (increase in urinary WBCs): infection, inflammation in
genitourinary system


2.2.3. Sediment Constituents
3. Epithelial Cells
+ Three types of epithelial cells in urine:
- Squamous
- Transitional
- Renal tabular


Squamous epithelial cell


Transitional epithelial cell


Renal tabular epithelial cell