相差显微镜检查尿沉渣上皮细胞黏附细菌对老年女性尿路感染的诊断意义

Clinical Relevance of Urinary Epithelial Cells Adhesive with Bacteria for Diagnosis of UTI in Old Women

目的探讨用相差显微镜检查尿沉渣中黏附细菌的上皮细胞对尿路感染的诊断意义。方法对55例年龄60～85岁、平均年龄(68.98±6.08)岁、反复发生尿路感染的老年女性患者进行尿沉渣相差显微镜检查共150例次,对部分患者尿标本进行沉渣涂片染色与相差镜检比较,同时进行尿常规以及尿细菌培养计数检查。比较治疗前后上述检查结果的变化,分析应用相差显微镜检出的附菌上皮细胞在诊断老年女性尿路感染中的意义。结果尿相差显微镜检查附菌上皮细胞是诊治女性、特别是老年女性尿路感染的特异性指标,与尿培养细菌计数结果成正相关(r=0.8888,P<0.05)。单独尿沉渣相差显微镜检查附菌上皮细胞诊断老年女性尿路感染的特异性为84.8%,单独尿常规白细胞计数的特异性为51.9%。结论尿相显微镜检查附菌上皮细胞是诊断尿路感染比较特异、敏感和简便易行的方法。

Objective To explore a simple and accurate method for diagnose and treatment of repeated urinary tract infection （UTI） in old female patients. Methods Fifty-five old female patients with repeated UTI were studied. Three methods including phase contrast microscopy examination, routive urine test and urine culture were used to identity if there were some correlations among them. And the specificity and sensitivity of each method were studied. Results The number of epithelial cells adhesive with bacteria significantly correlated with the number of bacteria in urine culture. But the number of urinary white blood cells did not significantly correlate with urine culture results. The sensitivity of the urinary sediment examination by phase contrast microscopy was about 84.8% , and the specificity of the urine routing test was lower, about 51.9%. Conclusion Finding the epithelial cells adhesive with bacteria by phase contrast microscopy examination might be a simple, specific and sensitive method for diagnose UTI.