When to indicate the presence or absence of the substance being tested, that is, the results of the qualitative test, generally "(+)" means positive; "(-)" means negative; "((±)" means "weak positive"; "(-)" means "negative". ±)" means "weak positive"; "(-)" means "negative".
The meaning of the + and - symbols in the medical report
"Positive" or "(+)" can indicate or represent an "abnormal result". For example: urine routine laboratory tests, urine protein "positive" or "(+)", which indicates that protein can be detected in the urine, protein in the urine is commonly found in kidney disease / heart failure / febrile diseases and urinary tract infections, etc., that is, the test results are abnormal, and need to attract The test results are abnormal and should be taken seriously. However, there are exceptions, such as Hepatitis B Surface Antibodies (abbreviated as HbsAb or anti-HBs), which are protective antibodies that neutralize the Hepatitis B virus and protect against re-infection. If the result of Hepatitis B "two-to-one half" test is "positive" or "(+)" for surface antibody, it means that there may be a history of Hepatitis B infection or hidden infection in the past, and now it is in the recovery period; it may also be the result of having received Hepatitis B vaccination. The purpose of hepatitis B vaccination is to produce antibodies to prevent hepatitis B. It can be seen that this purpose is "positive". It is good to be "positive" for this purpose.
The meaning of other symbols in the medical report
When it is necessary to indicate how much of the substance being tested, i.e., the result of a quantitative test, it is reported in the form of a "specific value" with a range of normal reference values for the result, but the normal reference values used in different hospitals / different methods of testing may vary slightly. Generally use "HIGH, H" and so on to indicate that "the value is higher than normal"; to "LOW, L" and so on to indicate that "the value is lower than normal "
General
In general, beyond the normal reference value range may belong to the abnormal, such as blood routine in the white blood cell (WBC) count for the quantitative test results, the normal adult reference value range for (4 ~ 10) × 10 μ μ / L. Leukocytosis is commonly found in severe trauma, infection, bleeding, poisoning, blood diseases, etc.; decrease in viral infections, severe sepsis, drug or radiation damage, and some blood diseases. and certain blood diseases.
For the abnormal test results, in addition to the above method of expression, some of the laboratory report form will also use special fonts or symbols (such as "*" or "!") to give emphasis to prompt attention.
Faced with a thick medical report, the data, charts, technical terms, and abbreviations are often confusing. So how do we properly understand the positive and abnormal results in a medical report? We consulted with Fu Zhigang, director of the physical examination center of the PLA 254 Hospital, and asked him to help us decipher the secrets of the physical examination report.
The two elements of the correct understanding of the medical examination
One time positive don't be afraid
Expert opinion: some medical examiners see the report of the physical examination of the positive results on the worry, the spirit of excessive anxiety is not necessary. Health checkups are the first screening for most people, some indicators are highly sensitive, some indicators themselves are at a dynamic level, the body detects the value of it in that moment, so just based on the results of the physical examination is not able to draw a direct conclusion, the need to repeat the test, or assisted by other indicators, other tests, **** with the diagnosis.
Taking hypertension as an example, people's blood pressure is fluctuating, and even if the blood pressure at the time of the physical examination is high, it can not be identified as hypertension, and need to repeat the examination a few times; similarly, a fasting blood glucose of more than 7mmol/L, can not be diagnosed as diabetes, and need to be reviewed and further do the two hours postprandial glucose, glucose tolerance and glycosylated hemoglobin and other tests in order to confirm the diagnosis.
No abnormality is not the same as no problem
Some medical examiners think everything is fine when they see that their indicators are not out of the normal range.
Expert opinion: the physical examination will have some checkups in the checkup indicators in the "critical value", although not to the extent of pathogenicity, but also for the health alarm, such as fasting glucose 6.1 ~ 7mmol / L people. For these "prospective patients", it is not necessary to take medication, but the adjustment of dietary structure, exercise is necessary to increase. When reviewing for a period of time, you should pay special attention to these items that have been at the threshold, and if you still can't get relief through a period of dietary and exercise adjustments, you should go to a specialist for further examination.
Special reminder of a note: continuous preservation of physical examination data
Longitudinal comparison is conducive to the early detection of disease. Such as a patient in a hospital to do a physical examination, found a small nodule on the liver, the doctor said it may be calcified foci, do not worry about it. When this patient brought last year's result to the doctor for comparison during her second year's physical examination, the doctor at the physical examination center said that the nodule had obviously become bigger and was probably a new organism, and suggested that she should undergo further examination. Eventually, it was determined that it was really a cancerous tissue.
This edition is written by Qiu Huayan, a reporter for the New Paper
The medical report is divided into three main parts
The first part is the part of the doctor's subjective diagnosis, which includes medical, surgical and ear, nose, throat and eye examinations, such as auscultation, otoscopy and vision tests, etc., and most doctors in this part will tell you the results directly.
Another part is the examination done by the medical department with the help of equipment, including routine examination such as electrocardiogram, blood pressure, etc., and imaging examination, such as ultrasound, chest X-ray or chest X-ray, etc. CT, MRI, etc. are seldom applied in the general routine medical checkups. The results of this part of the report are generally easier to understand, and if there is a positive result, the examining doctor will provide some suggested text to give advice on further treatment.
The most complicated and least understandable is the laboratory diagnosis, which is this part of the report from the laboratory.
The most common abnormalities in medical reports
●Electrocardiogram
T-wave abnormality: this is the most common abnormality in electrocardiograms, suggesting myocardial ischemia, which may be related to coronary artery disease, hyperkalemia, high blood pressure, or overfatigue prior to the examination, and is of reference value without being a basis for diagnosis.
Suggestion: Go to a cardiovascular specialist for further examination to rule out cardiac lesions.
●Abdominal ultrasound
Fatty liver
Suggestion: Mild fatty liver will be reduced by low-fat diet, moderate exercise and restriction of alcohol consumption, while moderate and above need treatment and regular ultrasound follow-up.
Kidney cysts: more than 2/3 are seen in people over 60 years old.
Suggestion: small, asymptomatic kidney cysts usually do not need treatment, multiple or with complications of kidney cysts need to go to urology or internal medicine for further treatment.
Gallbladder polyps
Suggestion: Consultation and treatment at general surgery or hepatobiliary surgery.
●Gynecological ultrasound
Uterine fibroids
Suggestion: small and asymptomatic fibroids can be left untreated, followed up for observation, and reviewed regularly. If there are symptoms, or if the fibroid is larger than two months pregnant, it can be treated surgically.
Ovarian cysts
Suggestions: benign, related to the menstrual cycle. Surgical removal depending on the condition.
Laboratory tests
Blood glucose (Glu): the basis for detecting diabetes. It can be physiologically increased, such as 1~2 hours after meal, emotional stress, etc. It can also be physiologically decreased, such as starvation, exercise, application of excessive insulin.
Suggestion: the general physical examination is mostly fasting blood glucose, in order to increase the accuracy should be tested at the same time two hours after meals blood glucose.
Urea nitrogen (BUN): the main indicator of kidney function. Physiological increase can be seen in high protein diet, strenuous exercise, age, tumor, etc. Pathological increase can be seen in kidney disease, pyloric obstruction, long-term diarrhea, severe vomiting, urinary stones, enlarged prostate, tumors, etc.
Suggestion: A mild elevation of urea nitrogen once in a while is not necessarily of clinical significance and can be rechecked. If the urea nitrogen is elevated several times in a row, it should be taken seriously, and it is recommended to go to the nephrology department for further detailed investigation.
Uric acid (UA, URIC): one of the important indicators of kidney function. Mild increase in uric acid is caused by high protein diet and does not require treatment; significant increase can lead to gout, gouty nephropathy and so on.
Suggestion: an occasional increase in uric acid is not necessarily of clinical significance, it is best to review, and a persistent increase should be treated in conjunction with clinical.
Total cholesterol (Tc, CHOL): persistent increase in total cholesterol is an important factor in atherosclerosis.
Triglycerides (TG): physiological increase is common in high-fat diet, obesity, etc. Pathological increase is seen in hyperlipoproteinemia, atherosclerosis, nephrotic syndrome, diabetes mellitus.
Low-density lipoprotein (LDLC): LDLC is a major lipid risk factor for coronary atherosclerosis.
Suggestion: There are many factors affecting blood lipids, and a mild increase in total cholesterol in an occasional checkup is not necessarily clinically significant. If the total cholesterol is elevated for several times in a row, it should be taken seriously, and it is recommended to combine it with other lipid indexes and clinical evaluation, and to reduce the intake of fat at the same time.
High-density lipoprotein (HDLC): the good cholesterol, its decrease is a risk factor for atherosclerosis, but the increase may not be proved to have additional protection against coronary heart disease.
Recommendation: A comprehensive evaluation in combination with other lipid measurements and clinical is recommended.
Alpha-fetoprotein (AFP): a major indicator for liver cancer screening and diagnosis.
Suggestion: If mild elevation of AFP is found during physical examination, it is recommended to review it; if it is persistently elevated for several times in a row, it should be highly valued and combined with other examination indicators and clinical for comprehensive judgment.
Carcinoembryonic antigen (CEA): a tumor marker for the gastrointestinal tract, which is also elevated when there is a long history of smoking and benign gastrointestinal diseases.
Suggestion: A mildly elevated test once in a while is not necessarily a malignant tumor and can be reviewed. If it is elevated several times in a row, it should be taken seriously.
Hepatitis B surface antigen (HBsAg), Hepatitis B surface antibody HBsAb, Hepatitis B e antigen (HBeAg), Hepatitis B e antibody (HBeAb), Hepatitis B core antibody (HBcAb): HBsAg, HBeAg, HBcAb is positive is usually referred to as the "triple positive", indicating active virus replication.
HBsAg, HBeAb, HBcAb positive is known as "small triple positive", for the hepatitis B virus carries, indicating that the virus has basically stopped replication, acute or chronic infection in the late stage. Replication, acute or chronic infection in the late stage, less infectious than the "big three positive". The "major triple positive" and "minor triple positive" reflect to some extent the number of hepatitis B viruses in the body and the degree of activity, indicating that the hepatitis B virus is infected or carrying the hepatitis B virus;
HBeAb, HBcAb positivity is what we call HBsAb, HBeAb, HBcAb are positive for the recovery of hepatitis B virus infection;
Only HBsAb is positive for the recovery of hepatitis B vaccine or hepatitis B infection in the past, and immunity to the hepatitis B virus has been achieved.