推荐回答(2个)
尿糖的检测的意义为:
一、用于诊断疾病:
正常尿糖为阴性,尿糖阳性时,临床意义为:
1、血糖过高性尿糖:常见于糖尿病、甲状腺功能亢进、肢端肥大症、巨人症、嗜铬细胞瘤、肝功能不全、胰腺癌、胰腺炎等。
2、肾性尿糖:常见于肾性肾小球肾炎、肾病综合征、间质性肾炎、家族性糖尿病等。
3、暂时性尿糖:可见于脑血管意外、心肌梗死、剧痛、妊娠性尿糖、新生儿肾小管重吸收功能发育不全出现的新生儿尿糖等。
二、用于糖尿病患者的病情监测:
对于大多数尿糖与血糖值平行的患者,可通过每日4次尿糖定性检查(3餐餐前和9~10pm)以及24小时尿糖定量可作判断疗效指标,并供调整降血糖药物剂量的参考。
直到自我血糖监测出现之前,尿糖的检查一直是每日评估糖尿病控制情况的主要方法。尿糖反映了在收集尿液期间的平均血糖浓度。葡萄糖在肾小球滤出,在近端肾小管被主动重吸收。葡萄糖的重吸收是有限的,其最大限度就是肾脏的葡萄糖阈值,当血糖浓度平均>10mmol/L时,将会超过此肾阈值,尿中出现尿糖。
尿糖测定目前多用试纸法。如果试纸显色则表示尿糖阳性,反之不显色则为尿糖阴性。
正常人尿液中葡萄糖为阴性,尿糖阳性见于糖尿病、肾性糖尿病、甲状腺机能亢进、急性应激情况下(如颅脑外伤、胰腺炎、心脑血管意外等),此处,内服或大量流向葡萄糖也可导致尿糖阳性反应。
与血糖相比,尿糖检查具有简便、无创、便宜等优点,但也存在以下一些缺点:
1. 一些糖尿病病程较长的患者,肾脏阈值较高,因此,在显著的高血糖状态下,尿中却不出现尿糖;
2. 妊娠妇女或儿童,肾脏阈值较低,因此在正常血糖浓度下,也会出现尿糖;
3. 肾脏糖阈值在不同患者之间发生变化,但是,在同一患者,不同的时间内,也会发生变化;
4. 有些药物及观察试纸变化的时间可以干扰尿液检查的结果,正确的检查方法是在尿糖试纸接触尿液后,一分钟内观察试纸的颜色变化;
5. 尿糖阴性结果不能区分低血糖、正常血糖及轻度的高血糖;
6. 在测尿糖之时,其结果并不能完全反映当时的血糖水平,而反映的是尿液潴留在膀胱中这段时间内的平均血糖水平,如果糖尿病患者同时伴有膀胱自主神经病变,则导致新近形成的尿液与潴留的尿液的混合,影响尿糖检查结果;
7. 液体的摄入量与尿液的浓缩稀释,均会影响尿糖结果。
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