A 56-year-old woman presented to the emergency department with a 3-week history of leg swelling. On physical examination, pitting edema in both legs was seen and a urine sample was collected. Laboratory studies were notable for a low serum albumin level and a very elevated urinary protein-to-creatinine ratio. Which of the following diagnostic tests is most likely to explain the appearance of the patient’s urine?
一名 56 岁女性因双下肢水肿 3 周至急诊科就诊。体格检查可见双侧下肢凹陷性水肿，并留取尿样送检。实验室检查提示血清白蛋白水平降低，尿蛋白/肌酐比值显著升高。下列哪项诊断性检查最有可能解释该患者尿液的表现？
A. Urinary chylomicron and triglyceride levels尿乳糜微粒及甘油三酯水平
B. Urine culture尿培养
C. Urine microscopy for dysmorphic red cells尿显微镜检（观察畸形红细胞）
D. Urine microscopy for white cell casts尿显微镜检（观察白细胞管型）
E. Urine protein electrophoresis尿蛋白电泳
答案解析：
该患者尿液呈乳白色，疑似乳糜尿，经检测尿乳糜微粒及甘油三酯水平升高后得以确诊。乳糜尿是由于淋巴系统与泌尿系统之间出现异常交通（瘘管）所致。其可能病因包括：淋巴丝虫病、先天性淋巴管畸形、创伤后淋巴管畸形以及肿瘤压迫淋巴管。经进一步系统检查，该患者最终确诊为淋巴管-尿路瘘所致的乳糜尿。
正确答案：A
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