Stanford A型主动脉夹层术前尿常规检测结果及临床分析

Routine urine and urinalysis in patients with Stanford type A aortic dissection

目的 探讨并分析Stanford A 型主动脉夹层术前尿常规检验以及镜检结果。方法 2007年1月至2013月5月，新疆维吾尔自治区人民医院72例Stanford A 型主动脉夹层患者临床资料，男性64例，女性8例。急性期41例，亚急性期20例，慢性期11例。选取年龄和性别匹配的59例体检健康人群为对照组。一次性尿杯留取患者清洁中段尿液，采用日本AX-4030全自动尿干化分析仪，Sysmex UF1000i尿有形成份分析仪测定尿糖、尿酮体、尿蛋白、尿胆红素、尿胆原、尿潜血、尿白细胞、镜检白细胞、镜检红细胞、镜检尿道上皮、镜检管型、镜检结晶。结果 Stanford A 型主动脉夹层组术前尿常规中指标尿糖阳性率26.39%，尿酮体阳性率25% ，尿蛋白阳性率41.67%，尿胆原阳性率15.23%，尿潜血阳性率41.67%，高于对照组，P〈0.05。镜检结果提示镜检白细胞阳性率26.39%，镜检红细胞阳性率26.39%，镜检上皮细胞阳性率12.5%，镜检管型阳性率8.33%，较之对照组升高，P〈0.05。结论 Stanford A 型主动脉夹层术前尿常规异常明显，全身炎症反应综合征和主动脉夹层自身解剖特点是引起主动脉夹层尿常规异常的主要原因。

Objective To investigate and analyze the results of routine urine routine test of preoperative patients with Stanford type A aortic dissection. Methods From January 2007 to Sep 2013, clinical data of 72 consecutive patients with Stanford Type A aortic dissection were retrospectively analyzed. 64 male patients and 8 female patients, based on disease course acute stage group（n=41）, subacute stage group（n=20）,chronic stage group（n=11）. 95 healthy people with similar age and sex were taken as the control group. Cleaning urine was collected by disposable urine cup. Urine indexes such as urine glucose, ketone body, protein, bilirubin, urobilinogen, occult blood, white blood cells, microscopic examination of white blood cells, red blood cells, epithelium, tube type, crystallization, were measured by AX-4030 urine dry chemistry analyzer, Sysmex UF1000i urine sediment analysis instrument. Results Positive rate of urine glucose（26.39%）, ketone body（25%）, protein（41.67%）, urobilinogen（5.56%）,occult blood（41.67%）, were higher than that of control group（P〈0.05）. Positive rate of microscopic examination of white blood cells（26.39%）, red blood cells（6.39%）, epithelium（12.5%）, tube type（8.33%） were higher than that of control group（P〈0.01） . Conclusion Urine routine abnormality was obvious in preoperative Stanford type A aortic dissection. Systemic inflammatory response syndrome and aortic dissection anatomical characteristics are the main causes of the abnormal urine routine of the aortic dissection.