尿液沉渣与干化学分析筛检尿路感染的临床价值  

Clinical Significance of Analysis of Urine Sediment and Strip for Screening Urinary Tract Infection

作　　者：范冰[1] 王瑞玲[1] 刘兰兰[1] 李迎丽[1] 

机构地区：[1]武警总医院检验科,北京100039

出　　处：《现代检验医学杂志》2012年第3期136-138,共3页Journal of Modern Laboratory Medicine

摘　　要：目的探讨尿液沉渣与干化学分析对尿路感染的筛检价值。方法对200例尿路感染可疑患者的中段尿标本进行细菌培养，然后利用iQ200尿沉渣分析仪和AX-4280尿干化学分析仪检测尿标本中的细菌（BACT）、酵母菌（YST）、亚硝酸盐（NIT）和白细胞酯酶（LE）；以细菌培养的结果作为金标准，评价各检测指标对尿路感染患者的筛检性能。结果200例尿培养标本中，阳性结果87例，占43．5％；与细菌培养相比，BACT，YST，NIT和LE的灵敏度分别为13．6％，16．7％，50．0％和63．2％，特异度为97．9％，100．0％，94．8％和70．8％，一致率为73．0％，90．0％，80．0％和67．5％，阳性预期值为72．7％，100．0％，82．5％和62．5％，阴性预期值为73．0％，89．8％，79．4％和71．4％。结论尿液沉渣与干化学分析不能有效地筛栓尿路感染，更不能取代细菌培养；但综合分析这些结果有助于对病人的早期诊治，并降低不必要的医疗费用．Objective To investigate the clinical significance of analysis of urine sediment and strip for screening urinary tract infection. Methods The midstream urine samples from two hundreds patients, who were suspected of urinary tract infection,were cultured for pathogen isolation and identification, then the content of bacterium （BACT）, yeast （YST）, nitrite （NIT） and leucocyte esterase （LE） in the samples were tested by the iQ200 urine sediment analyzer or the AX-4280 urine strip analyzer. The function of the indices above for screening urinary tract infection were also estimated with the result of the bacterial culture as the golden standard. Results From the two hundreds of urine samples for bacterial culture, eightyseven samples were positive, accounting for 43.5%. Compared with the urine culture, the sensitivity of BACT, YST, NIT and LE were 13.6%, 16.7%, 50.0% and 63.2% respectively, the specificity of them were 97.9%,100.0%, 94.8 and 70.8 % respectively, the crude agreement of them were 73.0% ,90.0 %,80. 0 % and 67.5 % respectively, the positive predictive value of them were 72.7%, 100.0% ,82.5% and 62.5% respectively,and the negative predictive value of them were 73.0% ,89.8% ,79.4% and 71.4% respectively. Conclusion Analysis of urine sediment and strip could neither screen urinary tract infection effectively, nor substitute bacterial culture;but analyzing the results comprehensively is helpful for early diagnosis and therapy of the patients and for reducing the unnecessary medical expenses.

关 键 词：尿路感染 筛检 沉渣 干化学 细菌培养 

分 类 号：R446.121[医药卫生—诊断学]