Hematuriamhq.ppt

血尿（Hematuria） 原南京中大附属医院神内科主任、硕士生导师 佛山大学医学院医学系孟红旗教授、主任医师 Professor、Doctor director 、Neurologist CONTENT Definition of hematuria Etiology Clinical feature Differential diagnosis Laboratory tests Accompanied symptoms DEFINITION More than three red blood cells are found in centrifuged urine per high-power field microscopy ( 3 RBC/HP). Normal urine: no red blood cell or less than three red blood cell 血尿基本定义 正常人尿液中无红细胞或偶见个别红细胞 血尿：尿液离心沉淀后尿RBC3/HP，或尿沉渣（Addi’s）计数12小时尿RBC50 万或 1小时10万 According to the amount of RBC in the urine, hematuria can be classified as: microscopic hematuria: normal colour with eyes gross hematuria: tea-colored, cola-colored, pink or even red 镜下血尿（microhematuria）：尿色正常，须经显微镜检查方能确定 肉眼血尿（macrohematuria）：尿呈洗肉水色或血色 泌尿道基本构成 肾 上尿路 输尿管 膀胱 下尿路 尿道（后尿道、前尿道） ETIOLOGY Diseases of the urinary system—the most common cause 1、Vascular arteriovenous malformation arterial emboli or thrombosis arteriovenous fistular renal vein thrombosis loin-pain(腰痛) hematuria syndrom excessive anticogulation 2、Glomerular IgA nehropathy thin basement membrane disease (incl.Alport syndrome) other causes of primary and secondary glomerulonephritis 3、Interstitial allergic interstitial nephritis analgesic(止痛剂) nephropathy renal cystic diseases acute pyelonephritis tuberculosis renal allograft rejection 4、Uro-epithelium malignancy vigorous excise trauma papillary necrosis cystitis/urethritis / prostatitis (usually caused by infection) parasitic diseases (e.g. schistosomiasis) nephrolithiasis(肾结石) or bladder calculi 5、System disorders a. Hematological disorders anemia leukemia allergic purpura hemophilia(血友病) ITP (idiopathy thrombocytopenic purpura) b. Infection infective endocarditis septicemia epidemic hemorrhagic fever (Hantaan virus)