18.下列何種檢查結果代表病人可能有腎前性氮血症(prerenal azotemia)?
(A)blood urea nitrogen /plasma creatinine(BUN/PCr)ratio< 10:1
(B)urine sodium(UNa)>40 meq/L
(C)urine osmolality <350 mOsmol/kg H2
O
(D)urine creatinine/plasma creatinine(UCr/PCr)>40
統計: A(56), B(22), C(32), D(186), E(0) #1740009
詳解 (共 5 筆)
腎前性急性腎衰竭可見血中尿素氮和肌酸酐皆上升,且其比值(A)blood urea nitrogen /plasma creatinine(BUN/PCr)ratio常超過 20 倍以上、
尿液滲透壓升高(C)urine osmolality (>500mosm/Kg)、
尿鈉偏低(B)urine sodium(UNa)(<20 mEq/L)、
腎衰竭指數(renal failure index,RFI= 尿鈉÷(尿中肌酸酐÷血中肌酸酐))小於 1、
鈉排泄分率(fraction of Na excretion,FENa= (尿鈉÷血鈉)÷(尿中肌酸酐÷血中肌酸酐)×100%)小於 1%
(A)blood urea nitrogen /plasma creatinine(BUN/PCr)ratio< 10:1其比值(A)blood urea nitrogen /plasma creatinine(BUN/PCr)ratio常超過 20 倍以上、
(B)urine sodium(UNa)>40 meq/L (B)urine sodium(UNa)(<20 mEq/L)、
(C)urine osmolality <350 mOsmol/kg H2 O
(C)urine osmolality (>500mosm/Kg)、
1. 血中尿素氮(BUN)的正常值在5~20mg/dl之間。在臨床上血中尿素氮和肌酸酐的比率(BUN/Creatinine ratio)平均值大約為10,如果比值大於平均值10,甚至是20
或者
2. (D) UCr/PCr >40 (UCr=urine creatinine, PCr=plasma creatinine) (正確)
往往表示係「非腎臟因素」的疾患所引起的腎前性氮血症(prerenal azotemia);
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TABLE 52-2 Laboratory Findings in Acute Renal Failure |
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|
Index |
Prerenal Azotemia |
Acute Tubular Necrosis |
|
BUN/PCr ratio |
>20:1 |
10–15:1 |
|
Urine sodium UNa, meq/L |
<20 |
>40 |
|
Urine osmolality, mosmol/L H2O |
>500 |
<350 |
|
Fractional excretion of sodium |
<1% |
>2% |
|
Urine/plasma creatinine UCr/PCr |
>40 |
<20 |
|
Urinalysis (casts) |
None or hyaline/granular |
Muddy brown |
