Lub tog raj kheej hauv cov zis yog cov me me ntawm lub raum kab noj hniav. Lub xub ntiag ntawm cov no qhia txog qee yam teeb meem kev noj qab haus huv. Cylindruria tshwm sim vim tsis txaus pom ntawm lub raum. Raws li txoj cai, qhov no cuam tshuam nrog qee yam pathology.
Lawv raug kuaj pom thaum lub sijhawm tso zis dav dav (ua luv OAM). Qhov kev tshuaj xyuas no tau pom zoo kom coj los ntawm txhua tus neeg uas tau thov rau lub tsev kho mob. OAM thiab ua tiav cov ntshav suav (CBC luv luv) pab txheeb xyuas ntau yam teeb meem kev noj qab haus huv hauv tus neeg mob. Tsis tas li OAM thiab UAC yog txheej txheem txheej txheem rau kev kuaj xyuas.
Lub tog raj kheej hauv tus menyuam cov zis
Cov zis feem ntau yog acidic me ntsis. Tus nqi pH yuav tsum tsis pub tshaj xya, qhov tsawg kawg nkaus tus nqi yog tsib thiab ib nrab. Cov thooj voos kheej kheej yog tsim nyob rau hauv cov zis, uas muaj cov tshuaj tiv thaiv acidic. Tsis tas li ntawd, OAM tuaj yeem pom cov protein ntau ntxiv.
Cov txheej txheem ntawm kev tsim ntawm lub cev microscopic qhia tias muaj teeb meem nrog raum. Feem ntau, cov cylinders tuaj yeem pom hauv cov zis, tab sis tsis pub ntau tshaj ob ntawm qhov pom.
Hom thiab ua rau
Lub tog raj kheej hauv cov zistuaj yeem tsim tau ntau txoj hauv kev:
- Yprotein;
- cov hlwb epithelial;
- erythrocytes.
Nws tseem ceeb heev uas yuav tsum nco ntsoov tias kev ua kom lub cev muaj zog lossis noj zaub mov muaj protein ntau yog vim li cas thiaj li pom cov hyaline pov tseg hauv cov zis.
Muaj peb pawg ntawm lub tog raj kheej hauv tag nrho:
- hyaline;
- grainy;
- waxy.
Tib lub sijhawm, granular tau muab faib ua ntau hom:
- erythrocyte;
- leukocyte;
- epithelial.
Hyaline
Hyaline casts hauv zis yog hom ntau tshaj plaws. Outwardly, lawv yog pob tshab thiab uniform. Qhov kawg ntawm lub tog raj kheej yog sib npaug. Nws yog ib qho tseem ceeb heev kom paub tias ib leeg (txog li ob) lub tog raj kheej hyaline uas tau txheeb xyuas los ntawm kev kuaj zis yog ib qho tshwm sim rau lub cev noj qab haus huv. Raws li tau hais ua ntej, yog vim li cas rau qhov no yog lub cev ua si thiab noj cov protein. Yog tias pom ntau ntawm lawv hauv cov zis, ces cov laj thawj yuav yog:
- jades;
- raum tuberculosis;
- dehydration;
- pathology ntawm lub plawv plawv (kab plawv);
- kab mob siab thiab lwm yam.
Muaj ob hom granular casts hauv zis:
- coarse;
- fine-grain.
Lawv tshwm sim los ntawm kev puas tsuaj rau cov tubules ntawm ob lub raum. Nyob rau tib lub sij hawm, cellular ntsiab disintegrate. Yog tias hom lub tog raj kheej no pom hauv cov zis, qhov no qhia tias muaj teeb meem loj rau lub raum:
- Yglomerulonephritis;
- sclerotic hloov pauv;
- nephrolithiasis;
- txhim kho malignant neoplasms hauv ob lub raum thiab lwm yam.
Nyob zoo
Waxy casts nyob rau hauv cov zis yog txawv kiag li nyob rau hauv tsos los ntawm lwm yam, raws li lawv muaj ib tug ntom qauv, lawv zoo li siv quav ciab. Qhov no yog ib qho phem heev hauv kev tshawb fawb, hom lub tog raj kheej no qhia tias qee cov tubules tau atrophied kiag li thiab tsis muaj cov zis tso rau hauv lawv.
Waxy casts tuaj yeem pom ntawm kev kuaj zis hauv cov xwm txheej hauv qab no:
- thermal (agonal) xeev;
- mob ntev heev ntawm glomerulonephritis;
- raum amyloidosis;
- nephrotic syndrome;
- raum mob raum thiab lwm yam.
RBC
Tam sim no luv luv txog erythrocyte casts hauv cov zis. Lawv raug tsim raws li hauv qab no: cov qauv erythrocyte yog superimposed los yog ua raws li cov qauv hyaline. Hauv qhov no, erythrocyte keeb tuaj yeem paub qhov txawv ntawm cov qauv ntawm lub tog raj kheej nws tus kheej. Qhov no yuav pab kom paub txog hematuria (uas yog, muaj cov casts hauv cov zis). Muaj cov xwm txheej thaum lawv ua homogeneous. Hauv qhov no, qhov laj thawj tuaj yeem yog:
- mob glomerulonephritis;
- raum mob plab;
- hlab ntshav thrombosis thiab lwm yam.
Lub xub ntiag ntawm cov qe ntshav liab yog ib txwm muaj kab mob. Sab nraud, qhov kev pom no muaj cov yam ntxwv hauv qab no:
- xim av;
- ntug tuaj yeem yogua tsaug;
- cylinders nkig heev.
txhawm rau txheeb xyuas erythrocyte casts, nws yog ib qho tsim nyog los tshuaj xyuas cov khoom tshiab xwb. Lawv tham txog kab mob raum thiab tso zis.
Pathological casts nyob rau hauv cov zis tuaj yeem ua rau tus kws kho mob paub meej tias cov txheej txheem pathological tshwm sim hauv tus neeg mob cov zis. Tus kws pab kuaj mob uas ua qhov kev tshuaj ntsuam xyuas yuav tsum tau qhia seb hom cylinders pom nyob rau hauv cov zis. Tam sim no luv luv txog ib hom ntxiv - lub tog raj kheej leukocyte.
Kev kuaj xyuas daim ntawv no qhia txog cov kab mob loj, ntawm cov pyelonephritis, sepsis, lupus nephritis thiab lwm yam tuaj yeem paub qhov txawv. Lawv raug tsim los ntawm kev ua raws ntawm leukocytes rau hyaline matrix. Leukocyte cam khwb cia yog qhov nyuaj rau kev kuaj pom, thiab hauv kev tshawb fawb ntawm cov zis tso quav, lawv tuaj yeem tsis meej pem nrog hom epithelial, uas peb yuav tham txog tam sim no.
Epithelial
Epithelial lub tog raj kheej yog cov qauv protein uas tsim los ntawm kev cog lus ntawm cov hlwb epithelial. Dab tsi ua rau lawv? Yog vim li cas rau lawv tsim yog nyob rau hauv lub lwj thiab dystrophic hloov nyob rau hauv lub tubules. Kev tshawb pom ntawm hom no qhia tau tias cov kab mob degenerative ntawm lub raum.
Lawv tuaj yeem tshwm sim hauv cov zis ntawm tus neeg mob lub raum tsis ua haujlwm uas nyuam qhuav tau hloov pauv. Lawv qhov kev tshawb nrhiav pom tau tias kev hloov pauv ntawm lub cev tsis lees paub. Txawm li cas los xij, qhov no tsis yog vim li cas rau lawv cov tsos ntawm cov zis. Lawv tshwm ntawm:
- mob tubular nephropathy;
- Yglomerulonephritis;
- terminalxeev thiab lwm yam.
Nws tseem ceeb heev uas yuav tsum nco ntsoov tias qhov pom ntawm cov thooj thooj voos kheej kheej no rau cov neeg mob glomerulonephritis yog ib qho cim tsis zoo (kev puas tsuaj rau cov tubular apparatus thiab qhov sib ntxiv ntawm cov nephrotic syndrome).
Pigmented
hom no muaj cov ntshav pigments uas yog xim av. Pigmented cam khwb cia hauv ntau txoj kev:
- thaum hloov ntshav tsis sib haum;
- thaum raug tshuaj lom thiab lwm yam.
Ib zaug ntxiv peb nco ntsoov koj tias txhua lub tog raj kheej tsuas tuaj yeem kuaj pom hauv cov zis nrog cov tshuaj tiv thaiv acidic, vim tias cov nyhuv alkaline rau lawv puas tsuaj. Hauv cov zis nrog cov tshuaj tiv thaiv alkaline, lawv yuav tsis raug kuaj pom tag nrho lossis tam sim no, tab sis muaj me me.
Thaum kuaj cov av, tsis txhob hnov qab tias tej zaum yuav muaj pseudocylinders tsim los ntawm mucus los yog uric acid ntsev.
