尿液中精液影响尿蛋白检测.doc

PAGE PAGE 1 尿液中精液影響尿蛋白檢測 永康榮民醫院 奚明德、梁俊珍、廖淑杏 摘要 目的：臨床上利用尿液蛋白質試紙，檢測尿液中蛋白質為篩檢腎臟疾病及肝臟病變之最方便、簡單與快速之檢測方法，為其主要優點。而其主要缺點為，較易因其他蛋白質引起偽陽性之結果。因此評估尿液中若含有男性精液，對於尿液蛋白產生偽陽性之結果。 檢體來源與方法：取37支來自新兵入伍篩檢尿液蛋白試紙微量反應（±，0.15-0.3 g/L）尿液檢體標本，進行尿液檢體離心（1,500 rpm, 5分），並於顯微鏡下觀察尿液沉渣，檢視尿液中是否含有精蟲。並於7-14日後，重新取尿液標本進行尿液蛋白試紙檢測及尿液沉渣鏡檢。 結果︰37支尿液蛋白試紙微量反應（±，0.15-0.3 g/L）尿液檢體標本，其中7支（7/37，18.9％）尿液中含有精蟲（sperms）。但是，經過7-14天後，經衛教告知驗尿前禁慾三天，方能收集尿液檢體，重新進行尿液蛋白試紙檢測，尿液蛋白檢測結果均為陰性反應。 結論：尿液中若含有精液、精蟲或前列腺素等，會使得尿液蛋白質試紙檢測呈現偽陽性結果。所以，當男性尿液蛋白質檢測時，若發現輕微蛋白尿反應，則應進行尿液離心，顯微鏡觀察尿液沉澱物，以確認是否為精液或其他因素所引起之尿蛋白反應，而非因腎臟疾病所引起之尿蛋白，以避免造成臨床診斷之困擾。 關鍵字： 蛋白尿（proteinuria） 微量蛋白尿（microalbumin） 尿液分析（urinalysis） 精液（semen） The false positive proteinuria in strips urinalysis caused by the presence of semen in urine Shi Ming- Der Department of Pathology and Laboratory Medicine, Yongkang Veterans hospital, Taiwan OBJECTIVES: Urine test strips are used to measure certain constituents in urine, which are significant of renal, urinary and hepatic disorders. Positive readings of protein in strip urinalysis may indicator renal disease. We evaluated the possibility that the presence of semen in urine may cause false-positive proteinuria. DESIGN AND METHODS: Urine specimens obtained from 37 young men in enlist physical examinations were directly applied on urine dipsticks (max. 1 sec.) for evaluation of the presence of more than 18 mg/dL and less 30 mg/dL protein. Isolated sperms and seminal fluid were also tested. All of urinalysis examined within 2 hrs of collection and was further performed with semen in urine sediment. All of positive finding will retest after 7 days from new collected urine specimens. These samples were dipstick tested for the protein. RESULTS: 11 urine samples were found of sperms. Seven out of eleven (64%) urine specimens yielded positive results for protein. After 7 days, recollected the seven young men urine that these samples were strips tested for the protein, all of the negative results. CONCLUSIONS: Semen, spermatozoa and semina