尿干化学和尿流式检测结果快速预测肾结石患者尿路细菌感染模型的建立与评价  

Establishment and evaluation of fast predictive algorithm for urinary tract infection pathogen in patients with nephrolithiasis

作　　者：肖楠[1] 周佳[2] 段宁 祝天阳 王利君[1] XIAO Nan;ZHOU Jia;DUAN Ning;ZHU Tianyang;WANG Lijun(Department of Laboratory Medicine,Beijing Tsinghua Changgung Hospital,Tsinghua University,Beijing 102218,China;Department of Clinical Laboratory,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]清华大学附属北京清华长庚医院清华大学临床医学院检验科,北京102218 [2]北京大学第一医院检验科,北京100034

出　　处：《检验医学》2021年第1期75-79,共5页Laboratory Medicine

摘　　要：目的建立一种可以通过尿干化学和尿流式检测结果预测肾结石患者尿路感染(UTI)的方法。方法分析414例肾结石患者的清洁中段尿样本,将尿流式细菌计数和亚硝酸盐、白细胞酯酶尿干化学检测结果与中段尿培养结果进行比对,确定阈值。结果尿流式细菌计数为231.8/μL时,检测敏感性为73.97%、特异性为91.14%。亚硝酸盐阳性[比值比(OR)作为7.789,95%可信区间(CI)为3.304~18.358,P<0.0001)]和/或白细胞酯酶4+的样本(OR值为2.738,95%CI为1.358~5.519,P=0.0049)更有可能提示尿路革兰阴性菌感染。结论建立的应用尿干化学和尿流式检测结果快速预测肾结石患者UTI的模型可预测革兰阴性菌和革兰阳性菌感染,有一定的临床应用价值。Objective To establish an algorithm that can predict potential pathogens causing urinary tract infection(UTI)based on routine urinalysis in nephrolithiasis patients.Methods A total of 414 clean-catch urine specimens of nephrolithiasis patients were collected.The comparison between flow cytometry count,nitrite,leukocyte esterase and urine culture was undertaken to assess the optimal cut-off value for predictive algorithm.Results The cut-off value of flow cytometry bacterial count was 231.8/μL(sensitivity 73.97%,specificity 91.14%).Furthermore,the samples with nitrite positive(OR=7.789,95%CI:3.304-18.358,P<0.0001)and/or leukocyte esterase 4+(OR=2.738,95%CI:1.358-5.519,P=0.0049)were more likely to contain Gram negative bacteria.Conclusion A fast predictive algorithmusing the combination of urine dipstick and flow cytometry can predict the infection of Gram-positive bacteria and Gram-negative bacteria in nephrolithiasis patientsand has certain clinical value.

关 键 词：肾结石 尿路感染 尿流式 尿干化学 

分 类 号：R446.5[医药卫生—诊断学]