实验诊断学之尿液肾功能检验ppt课件.ppt

二.白细胞和脓细胞(Leukocytes and purulent cells) 白细胞外形完整，分散存在，以中性粒细胞多见。脓细胞是指在炎症过程中破坏或死亡的中性粒细胞，外形不规则，常成堆聚集存在。 Leucocyte appearance, complete, scattered by neutrophils. Pus cell refers to the process of inflammation of the destruction or death, irregular shape neutrophils, often gathered there heaps 参考值：正常平均0-5个/高倍视野 Normal:0-5 white blood cells(WBSs)/hpf. 临床意义：若 有较多白细胞或脓细胞，多为泌尿系感染如肾盂肾炎、膀胱炎、尿道炎。 ( more white cells, or septic for urinary tract infection such as pyelonephritis, cystitis, urethritis) 三.上皮细胞(Epithelial cells) 1.肾小管上皮细胞：来自近曲小管和远曲小管，较多出现提示肾小管病变。慢性炎症时肾小管上皮细胞发生脂肪变性，称脂肪颗粒细胞。 Renal tubular epithelial cells: From the proximal convoluted tubules and far convoluted tubules, prompting renal tubular lesions. 2.移行上皮细胞：有尾形、小圆、大圆，来自肾盂、输尿管、膀胱，有炎症时在尿中出现增多.transitional epithelium cells :With tail shape, small circle, big circle, from the pelvis, ureter, bladder, when these parts inflammation, transitional epithelium cells appeared in the urine 3.复层扁平上皮细胞：来源于尿道前段，女性排除阴道分泌物污染后，且伴有尿白细胞增多，见于尿道炎。Stratified squamous epithelial cells: urethritis 肾小管上皮细胞 尾形、小圆、大圆上皮细胞 扁平上皮细胞 四.管型Casts 是滤出液中的蛋白质、细胞或其它物质在肾小管、集合管中凝固而成的类圆柱形蛋白聚体。其形成条件：(The proteins ,cell, or other substances in renal tubular collection, frozen tube of cylindrical protein together. ) 1.尿中有少量的清蛋白和由肾小管上皮细胞产生的T-H糖蛋白是构成管型的基质(A small amount of albumin and T - H glycoproteins) 2.肾小管有使尿液浓缩和酸化能力（浓缩可提高蛋白质含量、盐类浓度，尿液酸化后使蛋白质沉淀） (The tubular has ability to fully concentrated and acidify the urine ) 3.有交替使用的肾单位，处于休息状态的肾单位，尿液在肾小管内有一定的滞留时间，使蛋白质浓缩和凝结，当该肾单位活动时，已形成的管型随尿排出(Have the alternate use of renal units) 尿液中的管型和临床意义： 1.透明管型：由T-H糖蛋白和白蛋白构成，某些人在剧烈运动、发热、麻醉后等无肾脏器质性病变时有轻度增多，在慢性肾炎，肾病综合症，高血压肾损伤的增多。(hyaline casts: component by T - H glycoprotein and albumin,occur Chronic nephritis, Nephrotic syndrome, Hypertensive renal damage) 2.红细胞管型：基质中含有红细胞，最多见于急性肾小球肾炎。 (Red cell casts: Acute glomerulonephritis) 3.白细胞管型：含有白细胞，见于肾盂肾炎。 Leukocyte cast: Pyelonephritis 4.颗粒管型： (granular casts)基质中含有较多粗大颗粒，多见于急慢性肾小球肾炎初期，肾盂肾炎累及