1564例尿液干化学检测全阴性标本镜检分析

Microscopic study on 1 564 patients' negative results of urine test with dry-chemistry method

目的分析本实验室AX-4280全自动尿分析仪(尿液干化学法)检测的全阴性结果的尿液标本,为评价尿液干化学法全自动尿分析仪在临床尿液检测中的应用提供参考。方法对我院门诊尿液常规检测中的1564例全阴性标本进行尿沉渣检查,结果分成肾内科及泌尿科门诊组(A组,n=204)和非肾内科及泌尿科门诊组(B组,n=1360)两组进行统计分析。结果全阴性结果中白细胞假阴性(真阳性)的标本占4.54%,红细胞假阴性(真阳性)的标本占3.58%。其中肾内科、泌尿科204例病人中白细胞占6.86%、红细胞占6.37%。A组内男性白细胞假阴性率为3.63%,与女性细胞假阴性率为9.57%,两组比较,差异有统计学意义,(χ2=3.89,P<0.05)。A组红细胞假阴性率与B组红细胞假阴性率,两组比较,差异有统计学意义(χ2=5.30,P<0.05)。结论在使用干化学法尿液全自动分析仪做尿常规出现全阴性结果时,为了不漏诊,不误诊,有条件的实验室应全部进行尿沉渣分析仪或显微镜检查。

Objective To analyze the false - negative results of urine test （dry - chemistry method） with AX - 4280 urine automatic analysis instrument. To give reference for clinical application of this instrument in urine test. Method 1564 all negative results samples have been centrifuged and every urine sediment has been examined by microscope. The microscope results were divided into two groups and analyzed with statistics software. A group （n = 204） was patients from nephros internal medicine and urology department, and B group （n = 1360） was patients from none nephros internal medicine and urology department. Results Among the 1564 microscopic results, false negative rate of urine WBC was 4.54%and urine RBC was 3.58%. In group A, false- negative rate of urine WBC was 6.86% , urine RBC was 6.37%. In group B, false - negative rate of urine WBC was 4.19% ,urine RBC was 3.16% .The false - negative rate of urine RBC in group A was significantly higher than in group B （X^2 = 5.30, P 〈 0.05） . Conclusion Once all negative results appear in urinary routine examinations with dry chemistry automatic analyzer, urinary sediment examination should be processed. In advanced laboratory, an urine samples should be performed microscopic examination or examination with urine sediment analyzer in order to avoid clinical misdiagnosls.