尿液測量試紙呈陽性潛血反應之臨床意義

Clinical Implications of Positive Occult Blood in Urine Dipstick Test

盧星華(Shing-Hwa Lu)

《北市醫學雜誌》 2卷9期 (2005/09) Pp. 774-778

https://doi.org/10.6200/TCMJ.2005.2.9.01

摘要

無症狀的顯微血尿於臨床上是一個相當常見且重要的課題。許多可能的疾病均與此有關聯性。尿液測量試紙提供我們一種快速、便宜而方便的方法，用以偵測尿液中潛血的存在與否。正常情形下，尿液中紅血球之數目於每一高倍顯微鏡視野下應小於三個紅血球。而陽性的尿液測量試紙判讀結果所代表的意義可能為：1．血尿，2．血紅素尿，3．肌球蛋白尿。當我們以每一高倍顯微鏡視野下應大於三個紅血球定義為血尿時，尿液測量試紙的偵測敏感度高過90%。而其專一度則較低，代表了尿液測量試紙有較高的假陽性率。以尿液測量試紙來篩檢明顯的泌尿系統疾病的效果仍有相當程度的爭議。許多因素均會影響以尿液測量試紙測試來篩檢無症狀顯微血尿的效果及準確性。但是無論如何，以尿液測量試紙測試來篩檢血尿是合乎經濟效益的，而且建議成年人每年執行一次尿液測量試紙測試，以期早期診斷泌尿系統之癌症病變。

關鍵字

血尿 ； 尿液分析 ； 泌尿系統疾病

並列摘要

Clinically, asymptomatic microscopic hematuria is a very common and important issue in which may be related to several kinds of diseases. Urine dipstick test provides a quick and inexpensive method for detecting occult blood in urine. Microscopically, less than three red blood cells under each high power field of centrifuged sediment should be interpreted to be normal. The clinical implication of positive urine dipstick test could be hematuria, hemoglobinuria or myoglobinuria. The sensitivity of urine dipstick test in identifying hematuria is over 90%, defined as more than three red blood cells per high power field of centrifuged sediment examined microscopically. On the other hand, the specificity of the dipstick for hematuria in comparison with microscopy is somewhat lower which reflecting a higher false-positive rate with the dipsticks. It remains controversial in screening the urological disorders based on the results of positive urine dipstick test. Many factors could have impact on the efficacy and accuracy of the screening of asymptomatic microscopic hematuria using urine dipsticks. Nevertheless, it seems to be cost effective using urine dipsticks for the screening of hematuria. Annually check of urine dipstick for the adult is recommended for the early detection of urological cancer.

並列關鍵字

hematuria ； urinalysis ； urological diseases