The study of urine by the method of T. Amburzhe is one of the methods for determining the number of erythrocytes and leukocytes in the minute volume of urine.
The technique was proposed by T. Amburzhe in 1954 as a modification of the Kakovsky-Addis test and is currently used in practical medicine in the diagnosis of kidney pathology and the urinary system in general.
The need for such methods is dictated by the fact that in the usual study of urine sediment, no account is taken of its quantity, volume, as well as the amount of urine that was taken for centrifugation, and the field of view covering the microscope.
This method takes into account the above indicators and, as a result, eliminates possible errors.
An integral part of any medical research is the stage of preparation, on which the quality of the results obtained depends (so in the absence of a toilet of the genitals, distortions of the true number of leukocytes are possible).
The purpose of this analysis is determined by the attending physician. He is also authorized to explain the essence of the study being conducted and to give the patient instructions on how to prepare for urine collection. The day before the study, the patient needs to limit the intake of fluid consumed during the day and completely exclude at night.
In the morning, you need to carry out a hygienic treatment of the external genital organs and empty the bladder (this is done in a physiological way or by inserting a catheter into it), note the time and collect urine for research in a clean jar for 3 hours.
Method of conducting
The study is carried out in a clinical laboratory by a laboratory doctor.
Its implementation includes several stages:
- Remove 3 ml from urine collected over a 10-hour period.
- Place in a centrifuge for 5 minutes at 2000 rpm
- Take the supernatant liquid so that 1 ml of sediment remains at the bottom.
- Stir the sediment and fill the counting chamber with it, calculating leukocytes and erythrocytes in 1 μl.
Cells are calculated according to the formula: Q = (x 1000 v)/s t, where:
- Q is the number of cells in the volume of urine received per minute,
- x – the number of counted cells in the chamber (for leukocytes and erythrocytes separately)
- s – the amount of urine taken for centrifugation (10)
- v is the volume of urine received in 3 hours.
- t is the time during which the urine was collected (3 hours = 180 minutes).
The resulting number in 1 μl multiplied by 1000 (1 ml = 1000 μl).
Norms of indicators
Regardless of what kind of research is carried out, to interpret its results, you need to know the indicators that are characteristic of a healthy person under the same conditions, because without this knowledge, the diagnostic meaning of the results obtained is lost.
And therefore, scientists have determined that for a person with healthy kidneys and urinary system, in the urine analysis according to Amburge, the sediment is found:
- 2000 leukocytes.
- 1000 erythrocytes.
Allowable fluctuations of figures are possible within 10%.
Evaluation of results
The results of the test (the number of leukocytes and erythrocytes) are recorded on the direction that came to the laboratory along with urine, and sent to the attending physician. He, on the basis of laboratory data and knowledge of normal indicators, evaluates the results obtained by comparing the norm and information from the laboratory.
This helps the doctor diagnose diseases such as:
- Pyelonephritis is an infectious and inflammatory pathology of the kidneys, which is characterized by lesions of the renal calyces and pelvis (in the analysis there will be a significant increase in the number of leukocytes, with a normal or slightly altered content of erythrocytes),
- Glomerulonephritis is an autoimmune pathology of the kidneys, in which the renal glomeruli are affected by circulating immune complexes (diagnostic indicators will be opposite to pyelonephritis, i.e. an increase in the number of red blood cells will be expressed with a normal or slightly increased number of leukocytes).
- Cystitis is an inflammatory disease of the bladder (the number of leukocytes increases and the number of red blood cells remains unchanged)
- Purulent processes in the kidneys (accompanied by a sharp increase in the content of leukocytes in the urine and the norm for erythrocytes)
Reasons for possible deviations
For deviations, it is customary to consider a discrepancy with normal indicators by more than 10%. The reasons for the change in the number of formed elements in the urine sediment were partially considered in the previous section. To understand the reasons for the change in the cellular composition of urine, you need to know what these cells are responsible for.
Leukocytes are white blood cells, the main function of which is to protect the macroorganism (in this case, a person) from the effects of foreign agents (organic and inorganic origin), they take part in all typical inflammatory processes (migrate from the bloodstream to the inflammation focus, try to absorb foreign agent and delimit the affected area from healthy tissue).
Therefore, an increase in the number of leukocytes in the analysis by the Amburge method makes it clear that somewhere, along the length from the kidneys to the urethra, an inflammatory process is taking place. The exact location of the lesion is determined on the basis of complaints, anamnesis and additional research methods.
Erythrocytes are red blood cells, the main function of which is to carry oxygen to organs and tissues. A distinctive feature of erythrocytes is that they do not seek to leave the bloodstream into the lesion focus, but leave it when the structural and functional integrity of the blood vessel is disturbed.
Therefore, if, as a result of the analysis, a high content of red blood cells is found, then we can say that somewhere, along the length from the kidneys to the urethra, blood vessels were damaged.
Most often, this is facilitated by injuries of the mucous membranes of the urinary tract, urolithiasis, glomerulonephritis, tumor growth. The exact cause should be established by the attending physician based on complaints, anamnesis and additional research methods.
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