尿液镜检联合尿液干化学检验在尿常规检验中的价值分析

Value analysis of urine microscopy combined with urine dry chemistry in routine urine test

目的 研究尿液镜检联合尿液干化学检验在尿常规检验中的价值。方法 回顾性分析2000例(2000份)患者的尿液标本检验情况,所有尿液标本均进行尿液镜检和尿液干化学检验及联合检验。以临床病理结果为金标准,比较三种检验方法的阳性检出率及诊断效能。结果 尿液干化学检验检出阳性患者1937例,尿液镜检检出阳性患者1935例,联合检验检出阳性患者1985例。联合检验的阳性检出率99.25%高于尿液镜检的96.75%、尿液干化学检验的96.85%,差异有统计学意义(P<0.05)。2000例患者临床病理结果显示1987例为阳性,13例为阴性。尿液干化学检验的阳性预测值、阴性预测值、敏感度、特异度、准确度、约登指数、误诊率、漏诊率分别为99.64%、9.52%、97.13%、46.15%、96.80%、0.4328、53.85%、2.87%,尿液镜检分别为99.69%、10.77%、97.08%、53.85%、96.80%、0.5093、46.15%、2.92%,联合检验分别为99.85%、66.67%、99.75%、76.92%、99.60%、0.7667、23.08%、0.25%。三种检验方法的阳性预测值、特异度、误诊率比较,差异无统计学意义(P>0.05);联合检验的阴性预测值、敏感度、准确度高于尿液镜检、尿液干化学检验,漏诊率低于尿液镜检、尿液干化学检验,差异有统计学意义(P<0.05);联合检验的约登指数最高,其次为尿液干化学检验,尿液镜检最低。结论 在进行尿常规检验时,尿液镜检与尿液干化学检验的诊断价值无明显差异,但可以为尿液干化学检验的诊断提供良好补充,可将二者联合应用,在尿液分析中具有不可替代的作用。

Objective To study the value of urine microscopy combined with urine dry chemistry in routine urine test.Methods The urine samples of 2000 patients(2000 samples)were retrospectively analyzed.All urine samples were examined by urine microscopy,urine dry chemistry alone and in combination.With clinicopathological results as the gold standard,the positive detection rate and diagnostic efficacy of the three test methods were compared.Results There were 1937 positive cases detected by dry chemical test,1935 positive cases by urine microscopy,and 1985 positive cases by combined test.The positive detection rate 99.25%by combined test was higher than 96.75%by urine microscopy and 96.85%by urine dry chemistry,and the difference was statistically significant(P<0.05).The clinicopathological results of 2000 patients showed that 1987 cases were positive and 13 cases were negative.The positive predictive value,negative predictive value,sensitivity,specificity,accuracy,Youden's index,misdiagnosis rate and missed diagnosis rate of urine dry chemistry were 99.64%,9.52%,97.13%,46.15%,96.80%,0.4328,53.85%and 2.87%,those of urine microscopy were 99.69%,10.77%,97.08%,53.85%,96.80%,0.5093,46.15%and 2.92%,and those of combined tests were 99.85%,66.67%,99.75%,76.92%,99.60%,0.7667,23.08%and 0.25%.There was no statistically significant difference in positive predictive value,specificity and misdiagnosis rate among the three test methods(P>0.05).The negative predictive value,sensitivity and accuracy of combined test were higher than those of urine microscopy and urine dry chemistry,but the rate of missed diagnosis was lower than those of urine microscopy and urine dry chemistry,the difference was statistically significant(P<0.05).The Youden's index of combined test was the highest,followed by urine dry chemistry and urine microscopy.Conclusion There is no significant difference in the diagnostic value of urine microscopy and urine dry chemistry when performing routine urine tests,but they can provide a good complement to the diagnosis of urine dry chemistry,and the combined application of the two can play an irreplaceable role in urine analysis.