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肾功能检查说明啥问题
发布时间：2011-08-01      来源：

    人体肾脏有强大的贮备能力，在疾病早期时往往没有或极少出现征兆，诊断很大程度依赖于实验室检查。在血标本肾功能化验单上，常常可以看到这样几项：Cr、BUN、UA等。

    血肌酐(Cr)成人血清Cr值男性44～132微毫摩尔每升，女性70～106微毫摩尔每升。血肌酐能较准确的反应肾实质受损的情况，当Cr值持续增高时，提示已有严重肾小球损害。

    Ccr(内生肌酐清除率)正常值为80～120毫升·分，Ccr可反映肾小球滤过功能和粗略估计有效肾单位的数量，故为测定肾损害的定量试验。当Ccr低于40毫升·分时，应限制蛋白摄入；低于10毫升·分，是人工肾透析的指征。

    血清尿素(SU)和尿素氮(BUN)尿素是体内氨基酸分解代谢终产物，成人SU正常值1.78～7.14毫摩尔每升，BUN为3.56～14.28毫摩尔每升。与血肌酐相同，只有当肾小球滤过率降至正常的50%以下时，SU才会明显升高。SU增高表示：1.肾小球滤过功能损害；2.蛋白质分解代谢旺盛或蛋白质摄入过多。

    血尿酸和尿尿酸(UA)为核蛋白和核酸中嘌呤的代谢产物。成人UA浓度男性150～416微摩尔每升，女性89～357微摩尔每升。若排除外源性UA影响(如禁食含嘌呤丰富的食物3天)，同时测尿UA浓度，则更有诊断价值。1.若血UA升高而尿UA降低，提示肾小球滤过功能损伤；2.血、尿UA均升高，提示UA生成异常增多。常为遗传性酶缺陷所致原发性痛风、血液病、组织缺氧、肿瘤、抗癌药、长期使用利尿剂及某些抗结核药、慢性铅中毒及长期禁食者等继发性痛风。3.血UA降低而尿UA升高，提示肾小管重吸收UA损害，UA自尿中大量丢失，可见于间质性肾炎、范可尼综合征、慢性镉中毒、使用磺胺等。4.血、尿UA均降低，见于UA生成减少。如急性肝坏死、肝豆状核变性等肝功能严重损害，或参与UA生成的酶缺陷、使用抑制嘌呤合成的抗癌药、大剂量糖皮质激素等。(北京地坛医院钱晨)

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