全自动尿液分析系统的复检规则的建立与应用评估

Establishment and evaluation of the review rules of automatic urine analysis system

目的制定适合本实验室Sysmex全自动尿液分析系统的尿液镜检复检规则。方法随机选择2014年3月到5月天津市第五中心医院门诊患者225份尿液标本对现有尿液复检规则进行临床有效性验证,最终通过漏诊率与复检率的结果来评判所制定的复检规则的可行性。结果以镜检结果为标准,225份尿样进行复检规则的验证,其符合率为90.2%(203/225),真阳性率39.56%(89/225),假阳性率8.44%(19/225),真阴性率50.67%(114/225),假阴性率(漏诊率)1.33%(3/225),复检率29.78%(67/225)。3例假阴性标本,均非泌尿科和肾病科患者,白细胞、红细胞镜检结果在3-8个/HP范围内,不会漏诊严重肾功能异常的患者。结论所制定的复检规则能够有效地筛选出真正需要镜检确认的异常标本,提高了工作效率及检验质量。

Objective To establish the proper review rules of the microscopic screening for Sysmex automatic urine analysis in our Lab.Methods Collecting 225 randomly selected urine samples were tested to validate these review rules.Omission diagnostic rate and review rate were used to evaluate the clinical practicability of the review rules.Re-sults 225 urine samples were assayed to further verify these review rules.The consistency rate was 90.2%（203/225）, the true positive rate was39.56%（89/225）,the false positive rate was 8.44%（19/225）,the true negative rate was 50.67%（114/225）,the false negative rate（omission diagnostic rate）was 1.33%（3/225）,the review rate was29.78%（67/225）.The 3 false negative samples selected by these review rules didn’t come from the nephropathy department or the urology department.And the microscopic results of RBC and WBC form these 3 samples ranged 3-8cells/HP.Thus, these review rules could avoid the missed diagnosis of patients with severe renal dysfunction.Conclusion The review rules established from this study for our Lab can effectively detect abnormal urine samples and improve the efficiency and the quality of urinalysis in routine clinical practice.