广东省医院临床检验尿液沉渣的调查分析

Survey for sediment urinalysis in Guangdong province

目的了解目前我省临床实验室进行尿液沉渣分析检查的方法学现状及实验室间结果的可比性,进而评估我省临床实验室实施尿液沉渣分析检查规范化工作进展情况。方法通过对省内365间临床实验室进行调查问卷及分析各实验室对5个浓度尿液质控品的测定结果进行调查。结果①调查显示我省县级以上医院有74.8%仍用普通玻片(或加盖玻片)直接镜检进行尿液沉渣分析检查,只有25.2%的医院采用商品化尿液沉渣检测系统。②被调查的实验室在尿液沉渣分析检查的日常工作中符合我国血液学和体液学专家委员会公布《尿液沉渣检查标准化的建议》只占27.9%,不符合占72.1%。③各实验室对5个浓度尿液质控品的实验室间测定结果非常离散,CV达92%～200%。④商品化尿液沉渣检测系统有助于标准化尿液沉渣显微镜分析,但不同的系统,结果差异仍然较大。结论我省临床实验室开展尿液沉渣分析检查规范化工作仍然十分不足,实施尿液沉渣检查规范化是提高镜检结果的可比性和准确性的关键。

Objective The comparison of various methods of urinary sediment testing among the clinical laboratories in Guangdong province was discussed.The standardization of urinary sediment testing in clinical laboratories of Guangdong province was evaluated. Methods Five different concentration levels of urine controls were given to three hundred sixty five clinical laboratories in Guangdong province.All laboratories were asked to test them and give the feedback. Results The survey clearly demonstrate 74.8% of district hospitals still use the glass slide (or with coverslip)with microscope to do urinary sediment test.The rest of 25.2% groups use commercial systems.The results also shows only 27.9% of laboratories can meet the requirement of 《The suggestions for standardizatin of sediment urinalysis》 claimed by the hematology and urinalysis experts.The rest of 72.1% of laboratories failed to meet the requirement.The results of these five urine control samples were very discrete among those involving clinical laboratories.CV is even up to 92%~200%.Several commercial systems are available to help standardize microscopic analysis,but they all differ. Conclusion The level of standardization of urine sediment analysis in Guangdong is not so high.However the standardization level of urine sediment analysis is the key factor for the improvement of correlation and accuracy of microscopic test.