尿常规检查对尿路感染的诊断价值

Value of urine routine examination in diagnosis of urinary tract infections

目的分析尿白细胞、细菌计数、亚硝酸盐3个尿常规指标与尿培养之间的关系,以探讨尿常规检查对于诊断尿路感染的意义。方法对2012年1月-2013年1月送检的6427份疑似尿路感染患者3个尿常规指标和尿培养结果,进行统计分析。结果尿常规白细胞、细菌计数和亚硝酸盐的敏感性分别为51.7%、8.5%、13.2%,特异性分别为53.6%、96.1%、88.2%;尿白细胞以++++为判定值时,特异性可达85.6%;尿白细胞对于革兰阴性杆菌和革兰阳性球菌的敏感性和特异性差异均无统计学意义;尿白细胞阳性在真菌培养阳性样本中的敏感性(60.0%)明显高于细菌培养阳性(50.8%)(P=0.02)。结论尿白细胞与尿常规细菌计数和亚硝酸盐相比,尿白细胞敏感性最高,在筛查尿路感染中意义较大。

OBJECTIVE To analyze the correlation between the three urine routine indicators including the white blood cell （WBC）, bacterial colony count, and nitrite （NIT） and the urine culture so as to explore the value of urine routine examination in diagnosis of urinary tract infections. METHODS A total of 6427 cases of patients who were suspected for the urinary tract infections were submitted for the examination of three urine routine indicators, and the results of urine culture were statistically analyzed. RESULTS The sensitivities of the WBC, bacterial colony counts, and NIT were 51.7% ,8.5% ,and 13.2% ,respectively, and the specificities were 53.6%, 96.1%, and 88.2 % respectively. As the WBC was determined as ＋＋ ＋ ＋, the overai1 specificity could reach to 85.6 % there showed no significant difference in the sensitivity or the specificity between gram-negative bacilli and gram- positive cocci; The sensitivity of WBC was significantly higher in the samples with fungal culture positive （60.0%） than in the samples with bacterial culture positive（50.8%）（P=0.02）. CONCLUSION As compared with the WBC, bacterial colony counts, and NIT, the sensitivity of the WBC is the highest, it is of great signifi- cance in the screening of urinary tract infections.