尿干化学仪与尿沉渣仪联合检测尿液有形成分镜检复检规则的制定和应用  

Establishment and application of urine sediment criterion for microscopy review analyzed by urine dry chemical analyzer and urinary sediment analyzer

作　　者：王平平[1] 张善辉[1] 马文 

机构地区：[1]江苏省姜堰市人民医院检验科,江苏姜堰225500 [2]江苏省姜堰市血站,江苏姜堰225500

出　　处：《中国现代医学杂志》2012年第34期50-54,共5页China Journal of Modern Medicine

摘　　要：目的联合URIT500B干化学尿液分析仪和IQ200尿沉渣分析仪作为尿液有形成分自动化分析的流水线,制定针对该流水线的镜检复检规则。方法留取1 090份尿样先进行干化学检测(包括OB、LEU、PRO)和尿沉渣分析(包括RBC、WBC、CAST),再由两名主管检验师采用双盲法进行显微镜检查,取二人均值作为镜检结果,并以此为标准,对1 090份尿样检测结果进行镜检复检规则的设置,计算复检规则的真阳性率、假阳性率、真阴性率、假阴性率(漏检率)及复检率。另选择198份尿样对该复检规则进行临床有效性验证,以漏诊率和复检率评判该复检规则的可行性。结果采用OB与RBC、LEU与WBC、PRO与CAST一一对应的规则,该复检规则的真阳性率为36.06%(393/1 090),假阳性率为30.09%(328/1 090),真阴性率31.65%(345/1 090),假阴性率(漏检率)为2.20%(24/1 090)及复检率为38.62%(421/1 090);另取198份尿样进行复检规则的验证,其验证结果的复检率为36.36%(72/198),真阳性率为38.89%(77/198),假阳性率为25.76%(51/198),真阴性率为34.34%(68/198),假阴性率为1.01%(2/198),2例假阴性标本为红细胞漏检,均非泌尿科和肾病科患者,红细胞镜检结果在3～7个/HP范围内,不会漏诊严重肾功能异常的患者。结论针对本室尿常规流水线的镜检复检规则能够有效筛选出需要镜检的异常标本,保证尿检质量,提高尿检效率。[ Objective ] To establish the proper review rules for microscopy review analyzed by automatic urinalysis work station composed of URITS00B urine dry chemical analyzer and IQ200 urinary sediment analyzer. [ Methods] 1 090 urine samples were analyzed by automatic urinalysis work station and the parameters obtained from it included OB, LEU, PRO and RBC, WBC, CAST. Each urine sample was also examined microscopically by two tech- nologists using double-blind method. The average results got from the two men were regarded as the judging criterion. Based on it, the review rules for the 1090 urine samples tested by urinalysis work station were created, and the true positive rate, false positive rate, true negative rate, false negative rate and review rate of these review rules were calculated. Additional 198 urine samples were tested to validate the review rules. Omission diagnostic rate and re- view rate were used to assess the clinical practicability of the review rules. [ Results ] Examination was set up based on the above six parameters. The microscopic examination result was taken as the judging criterion. The true positive rate was 36.06% （393/1 090）, the false positive rate was 30.09% （328/1 090）, the true negative rate was 31.65 （345/1 090）, the false negative rate （omission diagnostic rate） was 2.20%（24/1 090）, and the review rate was 38.62% （421/ 1 090）, additional 198 urine samples were used to further verify the review rules. The review rate was 36.36% （72/ 198）, the true positive rate was 38.89% （77/198）, the false positive rate was 25.76% （51/198）, the true negative rate was 34.34% （68/198）, the false negative rate was 1.01% （2/198）. The two false negative samples selected by the review rules did not come from the nephropathy department or the urology department. RBC microscopic results of the two samples ranged 3~7 cells/HP. So the review rules could avoid the missed diagnosis of those patients with severe renal dysfunction. [ Conclusion ] The review rules establ

关 键 词：尿分析 显微镜检查 干化学 IQ200尿沉渣分析仪 

分 类 号：R446.129[医药卫生—诊断学]