尿液有形成分分析联合血清降钙素原检测在尿路感染诊断中的应用价值

摘要

Objective To investigate the role of urinary sediment analysis by UF-1000i urinalysis analyzer combined with serum procalcitonin(PCT) determination in the diagnosis of urinary tract infection. Methods A total of 1 372 urine specimens were collected in sterile process and determined for urinary bacterial culturing and the cut-off values of bacterium and white blood cell counts by UF-1000i. The result of urinary bacterial culturing was used as golden standard. The sensitivities and specificities were evaluated. The consistency of bacterium scatter diagram information of UF-1000i and urinary bacterial culturing was analyzed. Serum PCT levels of urinary bacterial culturing positive group,urinary bacterial culturing negative group,UF-1000i positive group and UF-1000i negative group were compared. Results The cut-off value of white blood cell count was 27.5/μL,and the cut-off value of bacterium count was 143.5 /μL. Using positive bacterium and white blood cell counts as screening parameters,the specificity was 92.7%,and the false negative rate was 30.8%. Using positive bacterium or white blood cell count as screening parameter,the specificity was 55.3%,and the false positive rate was 44.7%. The consistency of bacterium scatter diagram information of UF-1000i and urinary bacterial culturing was 57%. The level of serum PCT in UF-1000i positive group was higher than those in UF-1000i negative group and normal control group(P<0.05),but there was no statistical significance for UF-1000i positive group compared with urinary bacterial culturing positive group (P>0.05). UF-1000i positive group combined with serum PCT determination can improve specificity for urinary tract infection. Conclusions UF-1000i white blood cell and bacterium counts and serum PCT level could be used for screening urinary tract infection.%目的 探讨UF-1000i全自动尿有形成分分析仪(简称UF-1000i)联合血清降钙素原(PCT)检测在尿路感染诊断中的应用价值.方法 收集以无菌方式留取的尿液标本1372例,进行尿液细菌培养,并运用UF-1000i进行细菌计数和白细胞计数.以尿液细菌培养结果为金标准,得出UF-1000i细菌计数及白细胞计数的临界值,分析敏感性和特异性,并统计分析细菌散点图信息与尿液细菌培养结果的符合性.比较尿液细菌培养阳性组、尿液细菌培养阴性组、UF-1000i阳性组、UF-1000i阴性组与正常对照组(体检健康者87名)的血清PCT水平.结果 白细胞计数的最佳临界值为27.5/μL,细菌计数的最佳临界值为143.5/μL.以细菌计数阳性和白细胞计数阳性作为筛查指标时,特异性为92.7%,但假阴性率较高(30.8%);以细菌计数阳性或白细胞计数阳性作为筛查指标时,特异性为55.3%,但假阳性率较高(44.7%).UF-1000i细菌散点图信息与尿液细菌培养结果的符合率为57%.UF-1000i阳性组血清PCT水平高于UF-1000i阴性组和正常对照组(P<0.05),与尿液细菌培养阳性组比较差异无统计学意义(P>0.05).UF-1000i阳性组联合血清PCT检测可提高尿路感染诊断的特异性.结论 UF-1000i细菌计数、白细胞计数和血清PCT水平可作为尿路感染的快速筛查指标.