葡萄糖对尿液白细胞干化学法测定影响的探讨  

Investigation of the effects of glucose on urine leukocyte esterase test

作　　者：席雪芹[1] 穆原[2] 金跃[1] 

机构地区：[1]徐州医学院附属淮安医院检验科,江苏淮安223002 [2]南京医科大学第一临床医学院,江苏南京210029

出　　处：《检验医学》2009年第4期274-277,共4页Laboratory Medicine

摘　　要：目的分析葡萄糖(Glu)对尿液白细胞(WBC)干化学酯酶法(简称干化学法)测定的影响,以提高检测准确率。方法对584例WBC镜检阳性的临床尿液检测资料回顾分析其Glu和WBC干化学结果;选取只有WBC干化学结果分别为±、+、++、+++阳性的新鲜尿液各5份,每份2管(每管10 mL),分为Glu加入组和H2O2加入组,分别对每组样本加入不同浓度Glu和H2O2,并进行干化学测定。在Glu加入组每次测定的同时,用去除Glu模块的试条进行重复测定。结果584例尿检结果中,Glu+++组与Glu++++组的WBC干化学假阴性率均高于Glu阴性组(P=0.001,P=0.000)。WBC干化学阳性检出数随尿Glu浓度的升高而减少[优势比(OR)=0.100,P=0.000],但不受H2O2的影响。结论尿Glu浓度为83.33 mmol/L(15 g/L)时,尿WBC干化学测定已明显受干扰,其受干扰程度随尿Glu浓度的升高而增大,是Glu干扰了尿WBC干化学测定,而非Glu模块的反应产物H2O2。Objective To explore the effects of glucose （Glu） on urine leukocyte esterase test, and seek the strategy to ensure the accuracy of urinalysis. Methods Urinary leukocyte and Glu were measured by dry chemistry method, the results were analyzed retrospectively in 584 cases whose urinary leukocytes were identified positive by microscope. 5 fresh urinary samples of which leukoeytes were measured positive （ including _＋ , ＋ , ＋＋ , ＋＋＋ ） in urinalysis using dry chemistry method as well as the rest tests negative were divided into 2 tubes （ 10 mL per tube） Glu was added in one group, H2O2 was added in another group. Urines of the two groups were assayed by dry chemistry method. Additionally urinalysis performed in Glu-added group were repeated by urine dipstrip without Glu test film in the meanwhile. Results In the 584 cases, the false negative rates of Glu ＋＋＋ group and Glu ＋＋＋＋ group were higher than that of Glu negative group （P = 0. 001, P = 0. 000）. The positivities of urinary leukocyte assayed by dry chemistry method was de- creased while the Glu concentration increased [ odds ratio （OR） = 0. 100, P = 0. 000 ], but was not interfered by H2O2. Conclusions The interference occurs obviously when the Glu concentration in urine raises to 83.33 mmol/L （ 15g/L）, and grows intensively while the Glu concentration increases. The interference is just from Glu in urine, but not from H2O2 resulted in the reaction of Glu on the film of the dipstrip.

关 键 词：葡萄糖 白细胞酯酶 尿液分析 干化学法 

分 类 号：R446.12[医药卫生—诊断学]