非离心尿细菌及白细胞计数对儿童尿路感染的诊断价值

Diagnostic value of bacterial and white blood cell of non-centrifuged urine in children with urinary tract infection

目的探讨非离心尿液细菌及白细胞计数对儿童尿路感染(UTI)的诊断价值。方法收集2011年5月至12月就诊的疑似UTI患儿的清晨中段尿液,利用sysmex-UF500i全自动尿液有形成分分析仪对其细菌(BACT)及白细胞(WBC)进行检测,同时进行细菌培养。以尿培养结果作为尿路感染金标准,判断BACT、WBC的诊断性能。结果共285例患儿符合纳入标准,尿培养阳性率为22.5%,ROC曲线分析BACT最佳截值为129.0/μl,灵敏度和特异度分别为95.8%、77.3%,曲线下面积为0.938;WBC最佳截值为48.4/μl,灵敏度和特异度分别为93.8%、61.3%,曲线下面积为0.897。结论检测非离心尿液中BACT及WBC计数可为儿童尿路感染的早期诊断提供较为快速、准确的实验室依据。

Objective To evaluate the diagnostic value of bacterial （BACT） and white blood cell （WBC） of non-centri- fuged urine in children with urinary tract infection （UTI）. Methods The midstream urine samples of children with suspected UTI were collected in the early morning from May 2011 to December 2011. The BACT and WBC were analyzed via Sysmex- UFS00i automated urine flow cytometer and urine bacterial culture was conducted. The diagnostic values of BACT and WBC were evauated by the results of culture which was regarded as the gold standard of UTI. Results A total of 285 children were recruited in this study. The positive rate of urine culture was 22.5%; the best cutoff of BACT was 129.0/μl according to the receiver operating characteristic curve with sensitivity of 95.8%, specificity of 77.3% and area under curve of 0.938. The best cutoff of WBC was 48.4/μl, with sensitivity of 93.8%, specificity of 61.3%, and AUC of 0.897 Conclusions Detection of BACT and WBC in non-centrifuged urine can provide fast and accurate laboratory basis for diagnosis of UTI.