Principle: Take 1 drop of freshly mixed urine and drop it directly on the glass slide, cover it with a 18 mmX18 mm cover glass, and use an ordinary optical microscope to examine it. First use a low-power lens to observe the casts in at least 20 fields of view (can be identified with a high-power lens), and then use a high-power lens to observe the cells in at least 10 fields of view.

Evaluation: 1) Simple, easy, fast, and low cost; 2) It can maintain the original form of various tangible components to the maximum extent and avoid damage to the tangible components; 3) It is suitable for urine that is turbid and has a significant increase in tangible components. Specimens (such as gross hematuria, urine, etc.); 4) The positive rate is low, it can only be qualitative or semi-quantitative, and the reproducibility is poor, making it easy to miss the diagnosis.

Principle: Take 10mL of freshly mixed urine in a graduated centrifuge tube. The RCF (relative centrifugal force) is about 400g (1200~ Centrifuge for 5 minutes (1300 r/min), discard the supernatant and leave 0.2 mL of precipitate. After mixing, take about 20 μL of precipitate and apply it on a glass slide, cover it with a 18mm × 18mm coverslip and conduct microscopic examination.

Evaluation: 1) The positive detection rate is high, the reproducibility is good, and it is suitable for urine specimens with clear appearance and few tangible components; 2) The operation is cumbersome and time-consuming, may destroy the tangible components, and is difficult to standardize and accurately quantify. It can only Semi-quantitative method has been gradually replaced by the standardized urine sediment quantitative counting plate method; 3) The centrifugation method is the basis for the standardization of urine formed component examination, and the centrifugation method should be used as much as possible.

Principle: The main dyes are crystal violet and sand yellow. Due to the differences in the chemical properties of various types of cells, casts and other components in urine sediment, their physical adsorption and chemical binding of dyes are different. After dyeing, they show a specific color, with clear shapes and easy identification.

Staining effect: red blood cells are lavender; polymorphonuclear leukocytes have orange-red nuclei and visible granules in the cytoplasm; flash cells have light blue or blue nuclei and pale or light blue granules in the cytoplasm; epithelial cells The nucleus is purple and the cytoplasm is lavender to pink. Living cells are pink or uncolored, and dead cells are dark purple. Transparent casts are pink or lavender; granular casts are light red to blue; cellular casts are dark purple; fat casts are not colored.

Principle: The main dyes are alcian blue and paronin B. After staining, the cell nucleus and cast matrix can be stained blue with Alcian Blue, and the cytoplasm and ribonucleic acid (RNA) can be stained red with Penonin B, forming a clear contrast between red and blue, making it easy to compare and observe, and the cell structure is more clear. clear, especially the pathological components are easier to identify.

Staining effect: red blood cells are light red or colorless; polymorphonuclear leukocyte nuclei are dark blue, light blue or colorless; squamous epithelial cells are light pink or purple; transitional epithelial cells and renal tubular epithelial cells are purple red. Cellular casts appear light blue or dark blue; granular casts appear pink to dark purple.

It is the "gold standard" for urine formed component examination.

FAST-READ10 urine standardized sediment quantitative counting plate. Each board has 10 independent counting chambers, which can detect 10 inspection specimens. Each counting chamber contains 10 large squares, with a side length of 1mm. The volume of each counting chamber is 1ul. After being filled with urine, the number of formed components calculated is the number of cells or casts/ul. Standardized quantitative counting method.

Use a quantitative counting board to count the number of cells and casts excreted in urine within 3 hours, and then convert the number of cells and casts excreted in urine within 1 hour.

Most of them are non-glomerular hematuria, with normal red blood cells or single morphological red blood cells as the main component (>70%), and urine protein is negative or weakly positive. The shape and size of the red blood cells were normal, biconcave disc-shaped, and the cell membrane was intact. Occasionally, shadow red blood cells or acanthosis red blood cells are seen, but there are generally no more than two types of abnormal morphology.

Clinically seen in: ① Temporary microscopic hematuria: It can be seen in healthy people, especially after strenuous exercise, rapid marching, cold bathing, standing for too long or heavy physical labor in teenagers. ② Urinary system diseases: such as urinary system inflammation, tumors, tuberculosis, stones, trauma, kidney transplant rejection and congenital malformations, etc. Hematuria is sometimes the only clinical manifestation of urinary system malignancies. ③Reproductive system diseases: such as prostatitis, seminal vesiculitis, etc. ④Others: Bleeding diseases caused by various causes: such as idiopathic thrombocytopenic purpura (ITP), hemophilia, aplastic anemia, etc.

Mostly glomerular hematuria. The proportion of abnormal red blood cells in urine is greater than 70%, and there are at least 2 types. It is often accompanied by increased proteinuria and granular casts, red blood cell casts, renal tubular epithelial cell casts, etc.

Mixed hematuria indicates that red blood cells may originate from more than one site and may be glomerular or non-glomerular. There are not many diseases that cause mixed hematuria, but IgA nephropathy ranks first.

In certain chronic diseases (such as chronic nephritis, renal infarction, etc.), renal tubular epithelial cells are prone to fatty degeneration, with varying numbers and uneven distribution of fat particles or small fat droplet-like vacuoles appearing in the cytoplasm, called oval Fat body/fat granule cells are special structures that identify renal tubular epithelial cells. They show a "Maltese cross" under a polarizing microscope (if the fat droplets are too small, this structure may not be obvious).

When intravascular hemolysis occurs, free hemoglobin is excreted by the kidneys, resulting in hemoglobinuria, and part of it is reabsorbed and degraded by renal tubular epithelial cells to produce hemosiderin particles. If hemosiderin particles exceed the transport capacity of renal tubular epithelial cells, they will be deposited in the epithelial cells, and the cells will fall off and be excreted in the urine, forming hemosiderinuria. The urine sediment will appear blue particles after Prussian blue staining (i.e., a positive Rouse test) ), common in acute and chronic intravascular hemolysis (in acute intravascular hemolysis, hemosiderinuria will appear several days later)

For example, there are many fat particles or hemosiderin particles in the renal tubular epithelial cells, and they even cover the nucleus, which is also called compound granulocyte.

The presence of tubular epithelial cells in urine is common in renal tubular lesions. The appearance in piles indicates acute necrotic lesions in the renal tubules. About 1 week after kidney transplantation, more renal tubular epithelial cells appeared in the urine, and then gradually decreased and returned to normal. When rejection occurs, it can reappear in large numbers, and epithelial cell casts can be seen.

Superficial transitional epithelial cells (large round epithelial cells)

Middle transitional epithelial cells (caudal epithelial cells/spindle epithelial cells/renal pelvic epithelial cells)

underlying transitional epithelial cells

It mainly originates from the surface of the external urethral orifice and vagina. Under the influence of inflammation, the transitional epithelial cells of the bladder mucosa are prone to metamorphosis into squamous epithelial cells and are shed in the urine.

A small amount of squamous epithelial cells can be seen in the urine of healthy people. If they increase in large numbers and are accompanied by leukocytosis, it indicates inflammation of the urinary system.

Vaginal squamous epithelial cells are commonly derived from vaginal secretions in women and generally have no clinical significance.

Caused by glomerular or renal tubular hemorrhage, more common in acute glomerulonephritis, acute attack of chronic nephritis, renal hemorrhage, acute tubular necrosis, renal transplant rejection, renal vein thrombosis, malignant hypertension, lupus nephritis, Subacute endocarditis and IgA nephropathy.

The appearance of white blood cell casts in urine indicates infectious lesions of the renal parenchyma, which are seen in acute pyelonephritis, renal abscess, interstitial nephritis, acute glomerulonephritis, nephrotic syndrome, lupus nephritis, etc.

There are no renal epithelial cell casts in the urine of healthy people. If they appear, it indicates renal tubular disease and renal tubular epithelial cell degeneration and shedding, such as acute tubular necrosis, interstitial nephritis, nephrotic syndrome, late stage chronic nephritis, renal amyloidosis, Eclampsia and metal or drug poisoning, etc.

Renal epithelial cell casts appear in urine within 3 days after kidney transplantation, which is one of the reliable indicators of rejection.

Mainly seen in active glomerulonephritis, ischemic glomerular necrosis, renal infarction and nephrotic syndrome.

Casts filled with bacteria indicate bacterial infection of the renal parenchyma, such as infectious nephropathy.

The casts are filled with golden brown amorphous bilirubin granules, which are seen in severe jaundice.

It is found in the urine of healthy people, especially in the urine of women. If it appears in large amounts, it indicates urethral irritation or inflammation.

It often coexists with hyaline casts and is seen in patients with acute nephritis, renal blood circulation disorder, or renal irritation.

If there is a large amount of calcium oxalate crystals in fresh urine, accompanied by an increase in red blood cells, it indicates that urinary system stones may be caused by calcium oxalate crystals.

Uric acid crystals occasionally appear in healthy people, especially after eating purine-rich foods. If uric acid crystals continue to appear in fresh urine, they can be seen in hyperuricemic nephropathy and uric acid stones. They can also be seen in acute gout, acute fever in children, and chronic interstitial disease. inflammation

Generally of no clinical significance

Generally of no clinical significance

The appearance of ammonium urate crystals with large numbers of white blood cells is suggestive of cystitis.

It often appears simultaneously with phosphate crystals and has no special clinical significance.

Found in acidic urine and can be engulfed by white blood cells.

Commonly seen in obstructive jaundice, acute hepatic necrosis, liver cancer, cirrhosis, and acute phosphorus poisoning.

It is rarely found in the urine of healthy people, but appears in large amounts in kidney stones and bladder stones.

Found in acidic urine

Leucine and tyrosine are protein products, and they often appear together in urine. They are seen in acute liver necrosis, leukemia, acute phosphorus poisoning, etc. When there are large amounts of tissue necrosis, diabetic coma may occur.

Seen in patients with renal amyloidosis, urinary tract infection and chyluria.

Common sulfonamide drug crystals

After using contrast agents such as diatrizoic acid, diatrizoic acid, and diatrizoate meglumine, related crystals may appear in the urine.

It is more common in diabetic patients, female urine and alkaline urine.

Often caused by urine being contaminated by vaginal secretions.