尿流式有形成分和内毒素检测在泌尿道感染诊断中的应用评价

The evaluation of applications of urine visible components and endotoxin detection in the diagnosis of urinary tract infection

目的:评价中段尿内毒素检测和尿液流式有形成分分析在泌尿道感染诊断中的意义。方法:收集558例中段尿标本进行细菌培养,将革兰阴性杆菌培养阳性标本同时行内毒素和尿流式有形成分测定。采用受试者工作曲线(receiver operative characteristic curve,ROC)评价两种方法在泌尿道感染诊断中的价值。结果:尿培养阳性标本211例,阳性率为37.8%,133例革兰阴性菌阳性尿液中的内毒素和尿有形成分(白细胞数、细菌数、上皮细胞数和红细胞数)的检测灵敏度分别为85.1%,85.1%,63.8%,46.8%,63.8%;特异度分别为95.7%,62.8%,94.7%,76.6%,58.5%;ROC曲线下面积(AUC)为0.923,0.846,0.840,0.643,0.613。结论:中段尿内毒素检测及尿液细菌数、白细胞数分析是诊断泌尿道感染较为理想的检测项目。

Objective： To evaluation the significance of mid-stream urine endotoxin detection and urine visible components analysis in the diagnosis of urinary tract infection.Methods： All of 558 mid-stream urine samples were collected for bacterial culture.Endotoxin detection and flow of urine visible components analysis were used at the same time among the samples with a positive result from Gram stain negative bacillus.The value of both methods in the diagnosis of urinary tract infection was assessed with ROC.Results： There were 211 samples performed positive cultural results,with a rate of 37.8%.The sensitivity of endotoxin detection and flow of urine visible components analysis in 133 positive urine samples of Gram stain negative bacillus were as follows：85.1% for endotoxin detection,85.1% for WBC,63.8% for bacteria,46.8% for epithelial cells,and 63.8% for RBC;while the specificity（with the same order） were 95.7%,62.8%,94.7%,76.6%,58.5%.Areas under the ROC curve（with the same order） were 0.923,0.846,0.840,0.643,0.613.Conclusion： Mid-stream urine endotoxin detection and the analysis of bacteria or WBCs in urine were more ideal items in the diagnosis of urinary tract infection.