尿干化学与流式细胞术联合用于尿液有形成分镜检筛选的研究与应用  

Study and application of the combination of urine dry chemistry examination and urine sediment flow cytometry examination on the microscopic screening of the urine formed component

作　　者：马骏龙[1] 丛玉隆[1] 陆玉静[1] 王成彬[1] 刘培培[1] 张永强 凌励 

机构地区：[1]解放军总医院检验科,北京100853 [2]希森美康医用电子(上海)有限公司

出　　处：《中华检验医学杂志》2011年第6期494-500,共7页Chinese Journal of Laboratory Medicine

摘　　要：目的 制定针对UF-1000i尿液分析流水线（由UF-1000i尿流式分析仪和AX-4030尿干化学分析仪组成）自动化检测结果的尿液镜检复检规则.方法 收集2009年9月至2010年2月解放军总医院尿液常规标本共2 839份.首先利用UF-1000i尿液分析流水线对2 839份尿液标本进行有形成分分析（包括RBC、WBC、CAST）和干化学检测（包括ERY、LEU、PRO）.每份标本在尿液分析流水线上检测完毕后由选定的2名主管检验师采用双盲法做显微镜镜检计数,以2名主管检验师检测结果的均值作为镜检结果.以镜检结果为判断标准,采用UriAccess3.0软件对2 839份尿液标本的检测结果进行复检规则的设置和调试,计算复检规则的真阳性率、假阳性率、真阴性率、假阴性率（漏诊率）及复检率.再选择299份尿液标本对该复检规则进行临床有效性验证,最终通过漏诊率与复检率的结果来评判所制定的复检规则的可行性.结果 采用UriAccess3.0软件,根据2 839份尿液标本的6项检测项目的检测结果进行复检规则的设置和调试,筛选出37条需要复检的规则和27条无需复检的规则.以镜检结果为标准,该复检规则的符合率为81.11%（2 311/2 839）,真阳性率为40.51%（1 150/2 839）,假阳性率为16.17%（459/2 839）,真阴性率为41.00%（1 164/2 839）,假阴性率（漏诊率）为2.43%（69/2 839）,复检率为18.28%（519/2 839）.将制定的复检规则输入UriAccess3.0软件,选取299份尿液标本进行复检规则的验证,其验证结果符合率为82.27%（246/299）,真阳性率为36.12%（108/299）,假阳性率为16.39%（49/299）,真阴性率为46.15%（138/299）,假阴性率（漏诊率）1.34%（4/299）,复检率为19.06%（57/299）.对其中的4份假阴性标本进行分析,均为非泌尿科和肾病科患者,且RBC、WBC镜检结果均在3～8个/HP范围内,对严重肾功能异常患者不会造成漏诊.结论 针对UF-1000i尿液分析流水线制定的复检规则能�Objective To establish the proper review rules for the microscopic screening of urine analyzed by UF-1000i automatic urinalysis work station （composed of UF-1000i urine flow cytometer and AX-4030 urine dry chemical analyzer）.Methods A total of 2 839 random urine samples were collected at Chinese People′s Liberation Army General Hospital from September 2009 to February 2010, and were analyzed using UF-1000i urinalysis work station.The parameters obtained from UF-1000i and AX-4030 included RBC, WBC, CAST and ERY, LEU, PRO.After analysis by urinalysis work station, each urine sample was examined microscopically by two technologists using double-blind method.The average results got from the two technologists were regarded as the judging criterion.Based on the criterion, the review rules for the 2 839 urine samples tested by urinalysis work station were created and adjusted, and the true positive rate, false positive rate, true negative rate, false negative rate and review rate of these review rules were calculated.After that, 299 randomly selected urine samples were tested to validate these review rules.Omission diagnostic rate and review rate were used to assess the clinical practicability of the review rules.Results Thirty seven rules for microscopic review and twenty seven rules without further microscopic examination were set up based on six parameters using UriAccess 3.0 Software.The microscopic examination result was taken as the judging criterion, the consistency rate of these rules was 81.11%（2 311/2 839）, the true positive rate was 40.51%（1 150/2 839）, the false positive rate was 16.17%（459/2 839）, the true negative rate was 41.00%（1 164/2 839）, the false negative rate（omission diagnostic rate） was 2.43%（69/2 839） and the review rate was 18.28% （519/2 839）.Additional 299 urine samples were assayed using UriAccess3.0 software to further verify these review rules.The consistency rate was 82.27%（246/299）, the true positive rate was 36.12%（108/299）, the false positive ra

关 键 词：尿分析 化学 分析 显微镜检查 自动分析 

分 类 号：R446.12[医药卫生—诊断学]