尿常规检测在尿路感染诊断中的价值

Significance of routine urinalysis in the diagnosis of urinary tract infection

目的探讨尿常规检测在尿路感染诊断中的价值。方法收集586例尿常规检测及中段尿培养阳性患者和500名健康体检者尿液样本。通过应用受试者工作特征(ROC)曲线计算尿液白细胞(WBC)计数、白细胞酯酶(LEU)、亚硝酸盐(NIT)的曲线下面积(AUC)。计算尿WBC、LEU、NIT单项检测及联合检测对尿路感染首诊的敏感性、特异性、阳性预测值、阴性预测值。结果 WBC、LEU和NIT诊断尿路感染的AUC分别为0.852、0.822、0.706,WBC、LEU、NIT及3项串联、3项并联诊断尿路感染的敏感性分别为82.6%、83.6%、43.8%、41.4%、87.2%,特异性分别为74.0%、73.0%、96.8%、98.0%、67.2%,阳性预测值分别为78.9%、78.4%、94.1%、96.0%、75.7%,阴性预测值分别为78.4%、79.2%、59.5%、58.8%、81.8%。结论尿常规检测快速、简便,具备良好的敏感性和特异性,适用于尿路感染,特别是男性患者的早期诊断和快速筛检。

Objective To evaluate the significance of routine urinalysis in the diagnosis of urinary tract infection.Methods A total of 586 patients undergoing routine urinalysis and with mid-stream urine culturing as positive and 500 healthy subjects were enrolled. The areas under receiver operating characteristic( ROC) curves( AUC) of white blood cell( WBC),leukocyte esterase( LEU) and nitrate( NIT) were analyzed. The sensitivities,specificities,positive predictive values and negative predictive values of WBC,LEU and NIT serial and parallel detections were calculated.Results The AUC of WBC,LEU and NIT were 0. 852,0. 822 and 0. 706. The sensitivities of WBC,LEU and NIT serial and parallel detections were 82. 6%,83. 6%,43. 8%,41. 4% and 87. 2%,the specificities were 74. 0%,73. 0%,96. 8%,98. 0% and 67. 2%,the positive predictive values were 78. 9%,78. 4%,94. 1%,96. 0% and75. 7%,and the negative predictive values were 78. 4%,79. 2%,59. 5%,58. 8% and 81. 8%. Conclusions Routine urinalysis is a rapid and simple test with good sensitivity and specificity,and is applicable for the early diagnosis and fast screening of urinary tract infection,especially for male patients.