尿常规指标对尿路感染诊断价值的研究  

Study on the Value of Urine Routine Indexes in the Diagnosis of Urinary Tract Infection

作　　者：沈嘉[1] 侯彦强[1] SHEN Jia;HOU Yanqiang(Shanghai Songjiang District Central Hospital,Shanghai 201600,China;不详)

机构地区：[1]上海市松江区中心医院,上海201600

出　　处：《中外医学研究》2022年第9期70-73,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:研究尿常规定量指标和定性指标对尿路感染的(UTI)诊断价值,并比较WBC计数联合不同定性指标诊断价值差异。方法:收集上海市松江区中心医院2017年1月-2021年8月治疗的UTI患者42例及尿培养阴性的非UTI患者37例的临床资料进行回顾性病例对照研究。分析UTI患者中段尿病原菌特征,以尿液培养结果为金标准,分别分析尿常规定性和定量指标对UTI的诊断价值。结果:42例UTI患者尿液共培养出病原菌47株,其中革兰阴性(G^(-))菌32株,占比68.09%,革兰阳性(G^(-))菌12株,占比25.53%,真菌3株,占比6.38%,G^(-)菌中大肠埃希菌检出率(31.91%)最高,G^(-)菌中粪肠球菌检出率(10.64%)最高。尿常规定性指标中白细胞酯酶(LEU)、亚硝酸盐(NIT)、尿沉渣染色诊断UTI敏感度分别为85.71%、38.10%、52.38%,特异度分别为81.08%、89.19%、78.38%,Kappa值分别为0.669、0.264、0.302。WBC计数、WBC计数+NIT、WBC计数+LEU、WBC计数+沉渣染色、WBC计数+NIT+LEU+沉渣染色对UTI诊断的曲线下面积(AUC)分别为0.867、0.883、0.903、0.908、0.936,其中WBC计数+NIT+LEU+沉渣染色AUC高于WBC计数、WBC计数+NIT(P<0.05)。结论:UTI患者病原菌以G^(-)菌为主,尿常规定性指标LEU对UTI诊断价值较高,联合WBC计数+NIT+LEU+沉渣染色对UTI有较好的诊断价值。Objective:To study the diagnostic value of urinary routine quantitative and qualitative indexes in urinary tract infection (UTI),and to compare the diagnostic value of WBC count combined with different qualitative indexes.Method:The clinical data of 42 UTI patients and 37 non-UTI patients with negative urine culture treated in Shanghai Songjiang District Central Hospital from January 2017 to August 2021 were collected and analyzed by retrospective case-control study.The characteristics of urinary pathogens in the middle segment of UTI patients were analyzed.Taking the urine culture results as the gold standard,the diagnostic value of routine qualitative and quantitative indicators of urine for UTI were analyzed respectively.Result:A total of 47 strains of pathogenic bacteria were cultured from urine of 42 patients with UTI,including 32 strains of Gram-negative (G^(-)) bacteria,accounting for 68.09%,12 strains of Gram-positive (G^(-)) bacteria,accounting for 25.53%,and 3 strains of fungi,accounting for 6.38%.The detection rate of Escherichia coli (31.91%) in G^(-)bacteria and Enterococcus faecalis (10.64%) in G^(-)bacteria were the highest.The sensitivity of leukocyte esterase (LEU),nitrite (NIT) and urinary sediment staining in the diagnosis of UTI were 85.71%,38.10% and 52.38% respectively,the specificity were 81.08%,89.19% and 78.38% respectively,and the Kappa values were 0.669,0.264 and 0.302 respectively.The area under the curve (AUC) of WBC count,WBC count+NIT,WBC count+LEU,WBC count+sediment staining and WBC count+NIT+LEU+sediment staining were 0.867,0.883,0.903,0.908 and 0.936 respectively.The AUC of WBC count+NIT+LEU+sediment staining was higher than those of WBC count and WBC count+NIT (P<0.05).Conclusion:The pathogen of UTI patients is mainly G^(-)bacteria.The qualitative index LEU of urine routine has high diagnostic value for UTI.Combined with WBC count+NIT+LEU+sediment staining has good diagnostic value for UTI.

关 键 词：尿常规 尿路感染 白细胞酯酶 亚硝酸盐 尿沉渣染色 

分 类 号：R446.12[医药卫生—诊断学] R691.3[医药卫生—临床医学]