不同尿液标本采集方法对尿沉渣分析仪诊断尿路感染的价值

摘要

Objective To explore the value of Sysmex UF-1000i urinary sediment analyzer in diagnosis of urinary tract infection (UTI) and clarify the influence caused by different specimen on UF-1000i diagnosing UTI.Methods Totally 466 specimens examined bacterial culture and routine urinalysis were collected from patients suspected of UTI during July and August,2015 (samples of group A).148 specimens during late March and early April were gathered to implement a urine culture and then the rest of urine were detected byUF -1000i urinary sediment analyzer instantly(samples of group B).Bacteria and leukocyte counts were gathered and then receiver operating characteristic (ROC) carve was drawn regarding the " gold standard" as bacterial culture by SPSS18.0.Next,the threshold values of bacteria and leukocyte counts for diagnosis of UTI were found out.Meanwhile,itssensitivity,specificity,positiveegative predictive value,false positive/false negative value,and diagnostic accuracy were calculated.Results The cut off values to samples of group A were101.7 bacteria/μl and 18.8WBC/μl respectively and to samples of group B were 98.7 bacteria/μl and 11.1WBC/μl respectively.The area of Bacteria and leukocyte counts under ROC carve was 0.604 and 0.661 to samples of group A and 0.941 and 0.848 to samples Of group B.To samples of group B,combined Bacteria and leukocyte counts for UTI,the optimum sensitivity was 82.4％,specificity was 92.1％,positive predictive value was 77.8％,negative predictive value was 93.8％,false positive rate was 7.9％,false negative rate was 17.6％,and accuracy was 89.9％.Bacterial culture was reduced by 70.9％.Conclusion UF-1000i urine sediment analyzers have the value of early screening value and help to diagnose UTI.Urine that was sterilely collected and examined within two hours can make the value of UF-1000i maximized.%目的 探索SysmexUF-1000i尿沉渣分析仪定量检测结果中细菌和白细胞计数在诊断尿路感染中的价值,阐明标本采集送检的不同对UF-1000i诊断尿路感染的影响.方法 选取笔者医院2015年7月～2015年8月466例怀疑尿路感染的入院患者同时做细菌培养及尿常规的检验结果(A组标本),收集2016年3月下旬～4月上旬148例尿细菌培养清洁中段尿标本,接种之后立即送检尿常规检查(B组标本).取两组标本的细菌及白细胞计数结果,以细菌培养为金标准用SPSS 18.0统计软件分别绘制ROC曲线,求出尿沉渣细菌和白细胞计数诊断尿路感染的阈值,并计算其敏感度、特异性、阳/阴性预测值、假阳性/假阴性率和准确性,比较两组标本的各项指标.结果 尿沉渣细菌与白细胞定量检测最佳阈值,A组标本分别为101.7/μl与18.8/μl,B组标本分别为98.7/μl与11.1/μl.尿沉渣细菌与白细胞ROC曲线下面积,A组标本分别为0.604与0.661,B组标本分别为0.941与0.848.对B组标本而言,细菌与白细胞联合诊断尿路感染最佳敏感度为82.4％,特异性为92.1％,阳性预测值为77.8％,阴性预测值为93.8％,假阳性率为7.9％,假阴性率为17.6％,准确度为89.9％,并可将细菌培养降低70.9％.结论 UF-1000i尿液沉渣分析仪在诊断尿路感染中有早期筛选,辅助诊断的价值.标本达到无菌采集、中段尿并在2h内送检的要求才能使UF-1000i发挥最大价值.