一种新型尿液检测模式的探讨及其软件研究

Development of a new mode of urinary test and its software

目的探索新型的尿液检测模式并设计相应软件。方法通过5000例尿液样本的研究检验该模式及所制定软件规则的合理性及对检测精度的影响,旨在提高尿液检测速度的同时保证尿液检测质量。结果采用UriAccess软件将尿干化学、尿流式沉渣计数、尿沉渣显微镜检3种方法整合,通过计算机的智能筛选、模式匹配、优势互补,提交合理准确的整合性临床报告。如此,尿液检测的阳性率达69．49％,与3种方法共同进行的结果类似(74．86％,P>0．05);UriAccess整合模式对单纯干化学方法阳性及阴性的纠正率可达37．25％,与3种方法共同进行的效果相当(38．43％,P> 0．05);尿干化学+尿流式沉渣分析双重大筛选均未显示异常者占28．09％,其中96．48％的样本无异常发现,其余3．52％中,显微镜下主要可见草酸盐、尿酸盐、磷酸盐结晶及少数霉菌。当两种筛选结果发生差异时,对尿红、白细胞来讲,尿流式沉渣分析阳性的结果值得重视,必需辅以显微镜检确认;尿细菌分析两种方法均有一定的检测价值,可互为补充。结论尿干化学、尿流式沉渣分析及尿沉渣显微镜检三种方式的结合是目前尿液筛查的最佳分析模式。通过UriAccess软件进行整合既不影响该模式原有的尿液检测精度,又能大大提高尿液检测的速度,使其更加智能化。

Objective To explore a new mode of urinary test and to design the corresponding software. Methods Five thousand urine samples were analyzed in order to verify the rationality and reliability of the mode and the rule of the software established for the mode and to improve the speed of the urine testing and guarantee the quality of the test. Results The software UriAccess was used for integrating the three methods： the drop-stick test, the flow-cytometer sediment analysis and the urinary sediment microscopy, and the intelligent screening, the mode matching and the advantage complementation of the computer were used for providing a rational, accurate and integrated clinical report. The positive rate of testing with UriAccess mode was 69.49%, which was similar to that with each of the three methods independently （74. 86%, P 〉 0. 05 ） ; the positive and negative rates of the drop-stick test corrected by UriAccess integrated mode were 37.25%, which was also similar to that with each of the three methods independently （38.43 %, P 〉 0. 05 ） ;With both the drop-stick test and the flow-cytometer sediment analysis, no abnormal findings were found in 28.09% of samples among which 96.48% had no abnormal sediments while 3.52% had some oxalate, urate, and phosphate crystals as well as some mildews. If there was difference between the results of the two screening tests, the flow-cytometer sediment analysis should be preferred with the confirmation of the microscopy in testing of the red blood cells and the white blood ceils in urine while both the drop-stick test and the flow-cytometer sediment analysis were valuable in testing of bacteria in the urine. Conclusions At present the combination of the three major methods, the drop-stick test, the low-cytometer sediment analysis and the urinary sediment microscopy is the optimal analysis mode for the urine-screening test. The integration of UriAccess will not change the accuracy of this mode and can increase the speed of the urine test greatly and make it more intelligent.