胆总管腺癌患者尿铜升高引起尿蛋白定性过程中尿色变绿1例

A case of green urine in the qualitative analysis of urinary protein caused by elevated urinary copper in a patient with choledochal adenocarcinoma

患者女, 58岁, 肝功指标异常, 以梗阻性黄疸收住入院。患者尿蛋白阳性, 滴加磺基水杨酸复检过程中颜色变为绿色, 较为少见。根据患者实验室检查及其他辅助诊断, 查找变色原因疑为胆总管腺癌引发梗阻性黄疸, 进而使患者铜离子经胆汁排泄受阻, 铜随胆汁经血液循环后入尿使尿铜升高所致, 为临床检验发现该类现象提供了理论依据。

A middle-aged female with abnormal liver function indicators was admitted to hospital with obstructive jaundice.Urine protein of the patient was positive,and the color turned green during the retest with sulfosalicylic acid,which was relatively rare.According to the laboratory examination and other auxiliary diagnosis of the patient,the cause of the discoloration was found to be obstructive jaundice induced by choledochal adenocarcinoma,which impeded the excretion of copper ions through the bile of the patient.Copper enters the urine through the circulation of the bile,causing an increase in urinary copper.This provides a theoretical basis for the discovery of this phenomenon in clinical tests.