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男性孕檢腎功能檢查需要檢查哪些項目？

出處：網(wǎng)絡(luò)收集 日期：2024-06-22 10:07:15 編輯：秩名

腎功能檢查項目

衡量腎功能的變化和好壞，醫(yī)學上常用尿液顯微鏡檢查、化學檢查、血液的某些化學檢查等指標來進行，因此常用的腎功能檢查項目主要是包括了以下11種項目測定，具體的參考值和臨床意義可以參考以下數(shù)據(jù)。
 
1、 血尿素氮
 
參考值：正常情況：二乙酰-肟顯色法 1.8～6.8mmol/L 尿素酶-鈉氏顯色法 3.2～6.1mmol/L。
 
臨床意義：正常成人空腹時血尿素氮為3．2-7.1mmol/L(9-20mg/d1)。而患有腎小球腎炎、間質(zhì)性腎炎、急慢性腎功能衰竭、腎內(nèi)占位性和破壞性病變等情況的患者，尿素氮都是增高。
 
2、 血肌酐
 
參考值：正常情況成人男79.6～132.6μmol/L、女70.7～106.1μmol/L，小兒26.5～62.0μmol/L，全血88.4～159.1μmol/L。
 
臨床意義：當血肌酐超過133umol/L時意味著腎臟出現(xiàn)損傷，已經(jīng)腎功能不全、腎衰竭。
 
3、 血尿酸
 
參考值：正常情況成人男149～417μmol/L、女89～357μmol/L； >60歲男250～476μmol/L、女190～434μmol/L。
 
臨床意義：當血尿酸超過390μmol/L，才可診斷為高尿酸血癥。當血尿酸超過420μmol/L升時，高尿酸血癥已十分明確，
 
4、尿肌酐
 
參考值：正常情況嬰兒88～176μmmol•kg-1/d、兒童44～352μmol•kg-1/d；成人7～8mmol/d。
 
臨床意義：當血肌酐高時說明患者的腎功能出現(xiàn)了問題，腎臟代謝廢物的能力下降；尿肌酐偏低，腎臟也會發(fā)生病變。
 
5、尿蛋白
 
參考值：正常情況定性陰性
 
臨床意義：正常人每日自尿中排出約40～80蛋白，上限不超過150mg。
 
6、選擇性蛋白尿指數(shù)
 
參考值：正常情況SPI<0.1表示選擇性好、SPI0.1～0.2表示選擇性一般、SPI>0.2表示選擇性差。
 
臨床意義：當尿中排出大分子IgG的量少時，表示選擇性好。相反，表示選擇性差。
 
7、β2-微球蛋白清除試驗
 
參考值：正常情況23～62μl/mi
 
臨床意義： 增高時腎小管損害。
 
8、尿素清除率
 
參考值：正常情況標準清除值 0.7～1.1ml•s-1/1.73 m2 (0.39～0.63ml•s-1/m2)，最大清除值 1.0～1.6ml•s-1/1.73 m2 (0.58～0.91ml•s-1/m2)。
 
臨床意義：尿素清除率增加可體現(xiàn)在糖尿病腎病早期；降低，體現(xiàn)為急慢性腎功能衰竭、急慢性腎小球腎炎、腎病綜合征、腎盂腎炎等。
 
9、血內(nèi)生肌酐清除率
 
參考值：正常情況下成人血漿0.80～1.20ml•s-1/m2，尿液男0.45～1.32ml•s-1/m2、女0.85～1.29ml•s-1/m2，50歲以上每年下降0.006ml•s-1/m2。
 
臨床意義：內(nèi)生肌酐清除率降至0.5～0.6ml•s-l/m2(52～63ml/min/1.73 m2)時為腎小球濾過功能減退。同樣，慢性腎炎腎病型者，由于腎小管基膜通透性增加，更多的內(nèi)生肌酐從腎小管排出，其測得值也相應(yīng)增高。
 
10、尿素氮/肌酐比值
 
參考值：正常情況12:1～20:1。
 
臨床意義：增高會腎小球病變，降低則急性腎小管壞死。
 
11、酚紅(酚磺太)排泄試驗
 
參考值：正常情況：15min0.25～0.51(0.53)、30min0.13～0.24(0.17)、60min0.09～0.17(0.12)、120min0.03～0.10(0.06)、120min總量0.63～0.84(0.70)。
 
臨床意義：腎小管功能損害0.50(50%)時，開始表現(xiàn)有PSP排泄率的下降。
 

腎功能檢查項目查前準備

腎功能檢查項目有一項是腎臟病人最常做的檢查項目——尿常規(guī)檢查，該項檢查需要接受腎功能檢查項目的人提前做好準備。
 
1、晨起留尿
 
尿常規(guī)檢查前要空腹，不能喝水，也不能吃東西、吃藥。要送檢的尿液標本很重要，要求是要晨起留尿。晨尿是指早晨起床時第1次小便，尿液相對較濃，尿中的有形成分要比白天稀釋的尿液為多，比較容易發(fā)現(xiàn)尿液的異常，也可避免飲食、飲水、運動等因素的影響。
 
2、一小時內(nèi)送檢
 
留取的尿液標本應(yīng)在1小時內(nèi)送檢，以免因酸堿度的變化影響尿中的有形成分，如紅、白細胞的破壞或皺縮變形等等。
 
3、留中段尿
 
最好留取中段尿做檢查，以避免尿道口炎癥、白帶等物污染尿液影響檢查結(jié)果。
 

知識普及：

 
做尿常規(guī)的腎功能檢查項目，留尿有兩種方法，一是12小時尿液留取，即留晚7-晨7時的小便，到晚上7時先將小便排盡棄去，然后將晚7時后的小便留置在容器內(nèi)，一直留到次日晨7時尿為止。二是24小時尿液留取，即棄去起床時的尿（早晨7時），將7時以后的尿留置在容器內(nèi)，一直留到次日晨起床7時尿為止。女性月經(jīng)期一般不宜留取小便送檢，以免經(jīng)血混入小便，造成血尿的假象。
 

腎功能檢查項目檢查方法

腎功能檢查項目包含有10多種的項目測定，但常用的檢查方法其實算起來主要是有4種，包括內(nèi)生肌酐清除率檢查、血尿素氮和血肌酐測定、酚紅(PSP)排泄試驗、尿濃縮與稀釋功能試驗。
 
1、內(nèi)生肌酐清除率檢查
 
這在腎功能檢查腎小球受損程度時比較常見，具體操作是：試驗前和試驗日低蛋白飲食三天，禁食肉類，避免劇烈運動。試驗日早上8時排光尿，再于此后至次晨8時的24小時將尿液收入加入有甲苯防腐劑的潔凈容器內(nèi)在，留取的尿液標本應(yīng)在1小時內(nèi)送檢。
 
2、血尿素氮和血肌酐測定
 
這是腎功能檢查比較常用的檢查方法之一，具體操作是：取靜脈血1毫升，注入抗凝管內(nèi)，充分混勻。正常的血尿素氮為9~20毫克/公升，血肌酐為1~2毫克/公升。各種嚴重的腎臟疾病引起腎功能不全時全增高。
 
3、酚紅(PSP)排泄試驗
 
這也是腎功能檢查比較常用的檢查方法，具體操作是：驗前不能服用阿斯匹林、青霉素等藥物。試驗前及試驗中應(yīng)避免飲茶和咖啡等利尿飲料。試驗前20分鐘患者先去排尿，然后飲水300~400毫升，之后不再飲水。用1毫升注射器準確抽取0.6%酚紅溶液1毫升由靜脈注入。注射后于分別在15、30、60、120分鐘收集尿液一次，分別收集于清潔標本瓶內(nèi)，并及時送驗。
 
4、 尿濃縮與稀釋功能試驗
 
具體操作是：實驗日患者進行普通飲食。晝夜24小時內(nèi)每隔三小時排尿一次，分別收集于清潔標本瓶內(nèi)。
 

腎功能檢查項目多少錢

快節(jié)奏的生活方式、愈加沉重的工作負擔，加上各種高科技、化學成分的污染，腎病的發(fā)病率也越來越高。當大家感覺到腎臟不適時，及時到醫(yī)院就診很重要，如果擔心費用問題，大家可以事先了解一下腎功能檢查項目的大致費用。
 
腎功能檢查項目的費用與檢查項目、醫(yī)院規(guī)模和所用器材等有直接的關(guān)系。
 
1、檢查項目費用
 
經(jīng)了解，一般情況下，腎功能檢查項目主要有血肌酐、尿素氮、尿膽酸、尿常規(guī)檢查這幾種。其中血肌酐、尿素氮是直接主要反應(yīng)腎功能的指標，尿膽酸是間接反應(yīng)腎功能的指標，尿常規(guī)主要是看是否有尿蛋白、細胞管型等腎功能損害的現(xiàn)象。這四個檢查項目的費用都不貴，加起來費用大概是100-200元。但如果有附加其他檢查項目，如B超之類，價格又會有所不同，具體花費還是要看個人需要做到檢查項目有哪些。
 
2、不同醫(yī)院費用不同
 
腎功能檢查項目費用與醫(yī)院的規(guī)模、儀器設(shè)備、醫(yī)療水平、權(quán)威性有關(guān)。一般情況下三甲醫(yī)院的費用會貴一些，二甲醫(yī)院費用會便宜一些，但三甲醫(yī)院的醫(yī)療設(shè)備相對會更先進齊全。如果有購買醫(yī)保的朋友，腎功能檢查項目的花費是可以用醫(yī)保付款的。

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