健康人群尿液电导率参考区间调查及临床应用

Investigation on biological reference interval and clinical value of urinary conductivity

目的调查健康人群尿液电导率生物参考区间范围,探讨尿液电导率与其他参数的关系及临床应用。方法收集健康人群10119例(年龄为96岁以下,男性5074例,女性为5045例),各种泌尿系统疾病、糖尿病及尿崩症患者3449例随机中段尿液,检测尿液电导率;随机收集上述尿液250例,检测尿液电导率、渗透压、比重、肌酐、尿素、钠、钾、氯化物、尿酸。结果健康人群随机尿液的电导率呈正态分布;各年龄段之间F为15.73,P<0.001,差异极显著;男女之间F为5.90,P<0.05,差异显著;健康人群随机尿液电导率的生物参考区间见表1。各种疾病尿液电导率显示:尿崩症尿液电导率最低,依次为尿毒症、急性肾功能衰竭、慢性肾功能衰竭、泌尿系感染、继发性肾小球疾病、糖尿病、肾小管-间质疾病、原发性肾小球疾病及肾泌尿系肿瘤等。250例尿液电导率与尿液渗透压(r:0.894)、比重(r:0.727)、尿钠(r:0.698)、钾(r:0.563)、氯化物(r:0.758)、尿酸(r:0.521)、尿素(r:0.556)、肌酐(r:0.495)呈正相关。结论尿液电导率反映尿液电解质导电能力,与渗透压正相关,是诊断肾浓缩功能新参数;健康人群随机尿液电导率结果呈正态分布,且与年龄段差异极显著,与性别差异显著。

Objective To determine the biological reference interval of urinary conductivity in healthy people and to study the relationship between urine conductivity and other parameters as well as its clinical feasibility. Methods Conductivities of midstream urine specimen from healthy people （n = 10119,5074 males and 5045 females, aged under 96 years） or patients with different diseases （n = 3449） were determined. Among them the following parameters ： conductivity, osmolality, specific gravity, creatinine, urea, uric acid, sodium, potassium and chloride of 250 random urine specimens were simultaneously determined. Results The urinary conductivities in healthy people exhibited normal distribution and significant differences were found in the subjects with different age and sex. The reference range of urinary conductivity was between 10.42±4.61 mS/ch and 24.10±6.81 mS/ch in healthy people and between 7.95 mS/ch±2.40 and 18.01±5.90 mS/ch in the patients with different diseases. Conductivity determined was positively correlated with osmolality （r： 0.894） ,specific gravity （r：0.727） ,sodium （r：0. 698） ,potassium （ r：0. 563） ,chloride （r：758） ,uric acid （ r：0. 521 ） ,urea （ r：0. 556） and creatinine （r：0. 495）. Conclusions Urine conductivity,which determination is simple and rapid, may reflect the conductive capacity of electrolytes in urine and positively correlated with osmolality, so it can be used as a new parameter for urinalysis to diagnose renal concentrative function in routine laboratory.