1026例尿液红细胞形态检查患者的尿蛋白、管型检测结果分析

Analysis on the test results of urine protein and urine casts in 1026 patients with urine red blood cell morphological examination

目的为泌尿系统疾病或疑似泌尿系统疾病患者尿常规检测复检规则的制订提供依据。方法分析于该院红细胞(RBC)形态门诊就诊患者标本的尿液干化学分析仪法和醋酸加热法尿蛋白检测的符合率,干化学蛋白阳性、阴性标本和干化学、流式检测全阴性标本的尿沉渣镜检管型检出率。结果尿液干化学分析仪法和醋酸加热法对于尿蛋白检测的阴性符合率为96.11%,阳性符合率为96.96%。干化学蛋白弱阳性标本的镜检病理管型的检出率为93.92%,检测结果为1+的标本镜检病理管型检出率为90.91%,蛋白阳性检测结果为2+至4+的标本镜检病理管型检出率为100.00%。镜检检出病理管型的干化学蛋白阴性标本、干化学蛋白阴性且RBC/白细胞(WBC)阳性标本、尿液干化学和尿液流式检测全部阴性的标本分别占总标本的66.47%、56.24%、10.23%。尿液流式检测病理管型阳性标本的镜检病理管型检出率为94.20%。结论尿液干化学分析仪和醋酸加热法两种方法检测尿蛋白有较好的一致性;尿液蛋白阳性可以作为镜检的必须条件,但尿液蛋白阴性和尿液流式检测病理管型阴性不能作为不镜检的依据。

Objective To provide the basis for the establishment of re-examination rules for routine urine test in patients with urinary system diseases or suspected urinary system diseases.Methods The coincidence rate of urine dry-chemistry analyzer and acetic acid heating method for urine protein detection in patients who visited the urine erythrocyte morphology clinic in the hospital were analyzed.The detection rate of urine casts in the protein-positive,protein-negative,all negative samples detected by detected by dry-chemistry analyzer and flow cytometry were analyzed.Results The negative and positive coincidence rate of dry-chemistry urine analyzer and acetic acid heating method were 96.11% and 96.96% respectively.The detection rate of pathological urine casts in weak positive samples detected by dry-chemistry analyzer was 93.92%,in protein positive(1+)samples was 90.91%,and in protein positive(2+to 4+)samples was 100.00%.Microscopic examination showed that the protein-negative specimens,protein-negative while RBC/WBC positive,dry-chemistry and urine flow cytometry all negative specimens in which pathological urine casts were detected accounted for 66.47%,56.24% and 10.23% of the total samples respectively.The detection rate of pathological urine casts in urine flow-cytometry positive protein was 94.20%.Conclusion Dry-chemistry urine analyzer and acetic acid heating method have good consistency in detecting urine protein,positive urine protein can be used as a necessary condition for microscopic examination,but urine protein negative and urine casts negative detected by flow cytometry can't be used as the basis for excluding microscopic examination.