尿液流水线分析系统联合显微镜检对尿路感染的诊断价值

Diagnostic value of urine pipeline analysis system combined with microscopix examination in urinary tract infection

目的探讨Sysmex UC-3500尿干化学分析仪(简称UC-3500)与UF-5000尿沉渣分析仪(简称UF-5000)的相关参数联合尿沉渣显微镜检在诊断尿路感染(UTI)中的应用价值。方法对该院2021年2—3月1036例患者的清洁中段尿进行尿干化学分析、流式尿沉渣分析及尿离心显微镜检,另送尿培养鉴定,以尿培养结果作为“金标准”,分析尿中性粒细胞酯酶(LEU)、白细胞计数(WBC)、细菌计数(BACT)3项指标联合显微镜检诊断UTI的灵敏度、特异度、符合率。结果1036例尿标本中299例(28.86%)尿培养阳性,其中革兰阳性菌162例,革兰阴性菌108例,革兰染色不定的细菌仪器7例(阴道加德纳菌),真菌21例。仪器LEU+WBC+BACT 3项指标联合、显微镜检以及显微镜检联合仪器UTI报警诊断UTI的曲线下面积(AUC)分别为0.635、0.698和0.761;将显微镜检联合UF-5000的仪器UTI报警后,其诊断UTI的符合率由72.18%升高至79.90%。UF-5000的细菌革兰染色分型对革兰阴性菌的符合率(78.82%)高于革兰阳性菌的符合率(47.06%)。类酵母细胞数量(YLC)、显微镜检、YLC联合显微镜检判断真菌性UTI的AUC分别为0.943、0.918和0.941。结论显微镜检联合UC-3500、UF-5000相关参数可为疑似UTI患者的诊断提供快速且准确的参考。

Objective To investigate the application value of the related parameters of Sysmex UC-3500 urine dry chemistry analyzer(UC-3500)and UF-5000 urinary sediment analyzer(UF-5000)combined with urine sediment microscopic examination in diagnosing urinary tract infection(UTI).Methods The urine dry chemistry analysis,flow urine sediment analysis and urine centrifugal microscopic examination were performed on the clean midstream urine in 1036 patients in this hospital from February 2021 to March 2021.In addition,the urine culture identification was performed.The urine culture results served as"gold standard"for the diagnosis of UTI.The sensitivity,specificity and coincidence rate of 3-item indicators urine neutrophil(LEU),white blood cell count(WBC)and bacterial count(BACT)combined with the microscopic examination for diagnosing UTI were analyzed.Results Among 1036 cases of urine sample,299 cases(28.86%)were positive for urine culture,in which 162 cases were Gram-positive bacteria,108 cases were Gram-negative bacteria,7 cases were Gram-indeterminate bacteria(Gardnerella vaginalis),21 cases were fungus.The area under the curve(AUC)of instrument LEU+WBC+BACT 3-item combination,microscopic examination and microscopic examination combined with instrument UTI alarm for diagnosing UTI were 0.635,0.698 and 0.761,respectively,after the microscopic examination combining with instrument UTI alarm in UF-5000,its coincidence rate for diagnosing UTI was increased from 72.18%to 79.90%.The coincidence rate of UF-5000 bacterial Gram staining typing for Gram-negative bacteria was higher than that for Gram-positive bacteria(78.82%vs.47.06%).AUC of YLC,microscopic examination and YLC combined with microscopic examination for judging fungal UTI were 0.943,0.918,and 0.941,respectively.Conclusion The combination of microscopic examination combined with UC-3500 and UF-5000 related parameters can provide the rapid and accurate reference for the patients with suspected UTI.