尿沉渣工作站在肝病患者尿路感染中的诊断价值

Application value of urinary sediment workstation in diagnosis of urinary tract infection

目的:探讨Lab UMat尿沉渣工作站尿液白细胞数(LEU)、细菌定量计数(BAC)、粘液丝(MUC)等指标在尿路感染中的诊断价值。方法:应用Lab UMat尿沉渣工作站检测292例肝病患者尿液中LEU、BAC和MUC水平,并采用电化学发光免疫分析法和酶法检测血清降钙素原(PCT)、C反应蛋白(CRP)、直接胆红素(DBIL)、总胆红素(TBIL)和谷丙转氨酶(ALT)水平。以尿液细菌培养结果为金标准,评价LEU、BAC和MUC在尿路感染时变化特点及诊断价值。结果:肝病患者尿路感染以G-菌感染为主占80.5%,大肠埃希菌是主要致病菌,G+菌以屎肠球菌居多。以细菌培养结果为金标准,BAC在尿路感染诊断价值ROC面积为0.82,灵敏度为77.83%,特异度为90.2%;LEU ROC面积为0.85,灵敏度为87.6%,特异度为83.3%;MUC ROC面积为0.63,灵敏度为60.3%,特异度为72.7%。随着BAC水平的不断升高,尿LEU、MUC和血PCT、DBIL、TBIL水平均出现显著升高(t=13.8,t=12.3,t=4.5,t=15.2,t=11.6;和t=16.7,t=17.1,t=10.8,t=20.3,t=19.6;P<0.01)。结论:Lab UMat尿沉渣工作站对辅助诊断尿路感染具有较高价值。

Objective： To investigate the application value of urinary sediment workstation with the index of LEU, BAC, MUC in diagnosis of urinary tract infection. Methods：The levels of LEU, BAC and MUC from urine of 292 patients with hepatitis were detected by LabUMat urinary sediment workstation. The serum levels of PCT, CRP, DBIL, TBIL and ALT were detected by electrochemical luminescence methods and Immunoturbidimetric assays individually. Taking bacterial culture results as gold standard, the changing characterized and diagnostic value of LEU, BAC and MUC were evaluated. Results： Gram-negative bacteria of urine infection were the most common bacteria which accounted for 80.5%, while Escherichia coli took the most. And for Gram-positive bacteria Enterococcus faecium was the most common bacteria. Based on the gold standard of the bacteria cultures, the area under the receiver operating curve（AUC） of BAC was 0.82, and the sensitivity, specificity were 77.83%and 90.2%individually. The AUC of LEU was 0.85, and the sensitivity, specificity were 87.6%and 83.3%individually. The AUC of MUC was 0.63, and the sensitivity, specificity were 60.3%and 72.7%individually. With the rising levels of urinary BAC, the levels of LEU, MUC and PCT, DBIL, TBIL were significantly elevated（t=13.8, t=12.3, t=4.5, t=15.2, t=11.6; and t=16.7, t=17.1, t=10.8, t=20.3, t=19.6, P〈0.01）. Conclusion：LabUMat Urinary Sediment Workstation had a high value in diagnosis of urinary tract infection.