流式尿有形成分分析仪UF-1000i联合相差显微镜在血尿来源诊断中的应用评价

Evaluation of Clinical Application of Flow Cytometer UF-1000i and the Phase Difference Microscope in Diagnosing the Origin of the Hematuria

目的:评价UF-1000i流式尿有形成分分析仪、尿干化学分析仪及相差显微镜联合应用在血尿来源鉴别中的应用价值。方法:选取33例肾小球性血尿、23例非肾小球性血尿,分别用UF-1000i流式尿有形成分分析仪检测尿红细胞数量、尿70%红细胞前向散射光强度(RBC-P70Fsc)、尿红细胞前向散射光分布宽度(RBC-Fsc-DW);用URISYS2400尿干化学分析仪检测蛋白(PRO);用相差显微镜检测尿红细胞数量、畸形红细胞比率。结果:对于血尿来源的鉴别,UF-1000i检查的敏感度100%,特异度82.6%,相差显微镜检查的敏感度93.9%,特异度91.3%。UF-1000i诊断肾小球性血尿的敏感度、特异度ROC曲线下面积为0.966(P<0.01),相差显微镜诊断肾小球性血尿的敏感度、特异度ROC曲线下面积为0.967(P<0.01)。二者曲线下面积比较,差异无统计学意义(u=0.03,P>0.05),二者诊断血尿来源的准确度相同。尿干化学分析中,尿蛋白阳性对于判断肾小球性血尿的敏感度为81.8%,特异度为65.2%。结论:联合UF-1000i流式尿有形成分分析仪、尿干化学分析仪及相差显微镜是鉴别血尿来源的最好策略。

Objective：To evaluate the role of urine analysis by combining use of the UF-1000i flow cytometer,chemical strip test and the phase difference microscope in diganosing the origin of the hematuria.Methods：Thirty-three midstream urine samples from the patients with the glomerular hematuria and 23 midstream urine samples from the patients with the non-glomerular hematuria were collected.Each sample was examined in following aspects：counts of RBC,RBC-P70Fsc and RBC-Fsc-DW by UF-1000i flow cytometer;PRO by URISYS 2400 chemical strip analyzer;counts of RBC and proportion of abnormalities RBC by the phases difference microscope.Results：To diganosis of the origin of the hematuria,the sensitivity of the flow cytometer UF-1000i was 100%,and the specificity of it was 82.6%.The sensitivity of the phase difference microscope was 93.9%,and the specificity of it was 91.3%.The area under the ROC curve of the sensitivity and specificity was 0.966（P0.01）,which was from the flow cytometer UF-1000i in diagnosing the glomerular hematuria.The area under the ROC curve of the sensitity and specificity was 0.967（P0.01）,which was from the phases difference microscope in diagnosing the glomerular hematuria.There was no significant statistical difference （u=0.03,P0.05）,by comparing the areas under the ROC curve.The accuracies were conformity by the tow methods in diagnosing the origin of the hematuria.The sensitivity and specificity of the chemical strip analyzer with PRO positive in diagnosing the glomerular hematuria were 81.8% and 65.2%.Conclusion：Combining use of the chemical strip analyzer,flow cytometer UF-1000i and the phase difference microscope is the best method in diagnosing the origin of the hematuria.