IQ200全自动尿液分析系统在尿路感染筛查中的作用

IQ200 automated urinalysis system for screening urinary tract infection

目的:探讨IQ200全自动尿液分析系统在临床诊断尿路感染中的筛查价值。方法:232例清洁中段尿标本在作病原体定量培养后,立即用全自动尿液分析系统之AX4280干化学分析仪检测亚硝酸盐(NIT)、白细胞脂酶(LEU),用IQ200流式尿沉渣定量分析仪检测细菌(BACT)、酵母菌(BYST)、小颗粒(ASP)等5项参数。以细菌定量培养结果作为金标准,评价5种参数对尿路感染细菌检出的灵敏度、特异度以及假阳性率、假阴性率。结果:AX4280检测NIT、LEU的灵敏度分别为82.9%、80.7%,特异度为97.5%、47.7%,假阳性率为2.3%、52.3%,假阴性率为16.8%、19.2%;IQ200检测BACT、BYST、ASP的灵敏度分别为80.0%、85.0%、82.1%,特异度为96.4%、95.3%、55.9%,假阳性率为3.5%,4.6%、44.1%,假阴性率为20.0%、15.0%、17.9%。结论:IQ200全自动尿液分析系统对尿路感染有一定的筛查作用,但不能代替病原菌的分离鉴定,对筛查出的阳性标本应尽早做病原体的分离培养,以指导临床及时用药。

tract infection. Objective：To explore the significance of IQ200 automated urinalysis system for screening urinary Methods： The 232 midstream urine samples were subjected to quantitative measurement of pathogens followed by assessment of nitrite （NIT） and leukocyte esterase （LEU） by using an automated urinalysis system AX4280 chemical analyzer and determination of bacterium （ BACT）, yeast （BYST） and all small particles （ASP） via IQ200 flow urine sediment quantitative analyzer. The sensitivity, specificity, false positive rate and false negative rate of the 5 indices were assessed based on bacterial culture results, the gold standard for determination of urinary tract bacterial infection. Results： Measurement of NIT and LEU yielded a sensitivity of 82.9% and 80.7% ,specificity of 97.5% and 47.7% ,false positive rate of 2.3% and 52.3% and false negative rate of 16.8% and 19.2% based on AX4280, respectively. Assessment of BACT, BYST and ASP was associated with a sensitivity of 80.0% ,85.0% and 82.1% ,specificity of 96.4% ,95.3% and 55.9% ,false positive rate of 3.5% ,4.6% and 44.1% and false negative rate of 20.0%, 15.0% and 17.9% on the basis of IQ200, respectively. Conclusion： IQ200 automated urinalysis system is useful for screening urinary tract infection may yet replace the isolation of pathogen culture. Early implementation of pathogen isolation culture of midstream urine samples may be useful to guide clinical treatment.