全自动尿沉渣仪分析法与显微镜法判断血尿来源的准确性比较

目的对比全自动尿沉渣分析仪分析法和显微镜法判断血尿来源的准确性,为临床参考提供数据资料。方法 206例血尿患者作为研究对象,其中肾小球病变患者101例,非肾小球病变患者105例。分别用UF1000i全自动尿沉渣分析仪(简称UF1000i)分析法和显微镜法分析尿液中红细胞(RBC)的形态,判断其来源并统计分析其检测性能的优劣。结果显微镜法的敏感性为88.1%,特异性为74.3%;UF1000i分析法的敏感性为92.1%,特异性为82.8%,2种方法检测结果的差异有统计学意义。受试者工作特征(ROC)曲线分析发现,显微镜法ROC曲线下面积(AUC)为0.869,UF1000i分析法AUC为0.928。结论 UF1000i分析法在肾小球性和非肾小球性血尿的鉴别中具有高敏感性和高特异性,其判断血尿来源的诊断价值优于经典相差显微镜法。     

自动尿沉渣仪分析法与显微镜法判断血尿来源的准确性比较

目的比较自动尿沉渣分析仪与显微镜法判断患者血尿来源的准确性。方法选取确诊的血尿患者160例,其中肾小球性血尿84例,非肾小球性血尿76例。留取其新鲜尿液标本,分别用自动尿沉渣分析法和显微镜法两种方法检测患者的尿液标本的红细胞形态,判断其血尿的来源,比较两种方法的灵敏度和特异度。结果自动尿沉渣分析法检测血尿来源灵敏度为94.1%,特异度为85.5%;显微镜法检测灵敏度为89.3%,特异度为69.7%。两种方法比较差异有统计学意义(χ2=8.43,P<0.05),认为IQ-200自动尿沉渣分析法检测患者血尿来源能力优于显微镜法。结论自动尿沉渣分析法相比于显微镜法,判断患者血尿来源的灵敏度和特异度均较高,且准确性较显微镜法好,值得临床推广使用。     

全自动尿沉渣分析仪鉴别血尿来源的价值

血尿是泌尿系统疾病最常见的症状,如何确定血尿的来源成了肾病科医生较为棘手的问题。我院于2000年购进uF—100全自动尿沉渣分析仪,我们用这台仪器进行红细胞形态分析诊断肾小球性血尿和非肾小球性血尿,取得满意效果,现报告如下。     

全自动尿沉渣仪分析法与尿沉渣显微镜镜检的应用价值

[目的]探讨尿沉渣分析仪、尿干化学分析仪及涂片显微镜检测方法的临床应用价值。[方法]采用UF-100型全自动尿沉渣分析仪、JUNNUR—Ⅱ尿干化学分析仪、手工涂片尿沉渣显微镜镜检对560份住院患者的尿液标本沉渣进行检测。[结果]尿干化学法、尿沉渣分析仪法及显微镜镜检法检测白细胞阳性率分别为55．18％、58．57％、56．25％,检测红细胞阳性率分别为63．21％、60．18％、56．43％,差异无统计学意义（P〉0．05）。[结论]尿干化学法、尿沉渣分析仪法及显微镜镜检法检测具有很高的准确性和敏感度,为泌尿生殖系统、循环系统、内分泌系统等疾病的诊断提供了可靠的数据。     

尿沉渣分析仪联合显微镜检查血尿来源102例的临床应用

目的探讨尿沉渣分析仪与显微镜联检对鉴别血尿来源的临床应用价值。方法用经临床确诊的102例肾小球和非肾小球疾病患者的新鲜中段尿作仪测尿红细胞形态相关信息、尿沉渣红细胞形态学检查和部分理化指标的测定,比较分析检验结果。结果 51例肾小球疾病中仪测法和显微镜法的临床诊断符合率分别为90.2%和94.1%;51例非肾小球疾病中仪测法和显微镜法的临床诊断符合率分别为88.2%和92.2%。如以非均一性红细胞为鉴别肾性血尿的标准,显微镜法和仪器法的敏感性、特异性分别为94.1%、92.2%和90.2%、88.2%;尿沉渣分析仪与显微镜联检的敏感性和特异性分别为96.1%、94.1%。结论尿沉渣分析仪与显微镜联检对鉴别血尿来源具有重要参考价值。     

UF-100尿沉渣分析仪与相差显微镜在鉴别血尿来源中的应用

目前．鉴别血尿来源的方法很多：有普通显微镜、相差显微镜、电镜、血液分析仪、尿沉渣分析仪等。普通显微镜由于缺乏色泽对比和立体感，需要有丰富熟练的尿形态学检验工作经验者。且最理想是染色。但较麻烦，故开展甚少；相差显微镜法反映尿红细胞形态立体感强，善于分辨；电镜法由于价格昂贵一般医院难以用于临床：血液分析仪测定尿红细胞体积。有客观快速、重复性好的特点。但易受其他微粒的干扰；     

U F-1000i 尿沉渣分析仪与相差显微镜在血尿来源鉴别诊断中的比较

目的：评价 UF‐1000i 尿沉渣分析仪与相差显微镜在血尿来源鉴别中的价值。方法该院肾内科2013年12月至2014年5月确诊的血尿患者98例,均进行尿沉渣检测和尿相差显微镜镜检,以临床诊断结果为标准,计算 UF‐1000i 尿沉渣分析仪与相差显微镜镜检的灵敏度及特异度,并进行比较。结果 UF‐1000i 尿沉渣分析仪的灵敏度（95．3％）高于相差显微镜（81．9％）,差异有统计学意义（P＜0．05）,而相差显微镜的特异度（92．3％）高于 UF‐1000i 尿沉渣分析仪检查的特异度（89．2％）,差异有统计学意义（P＜0．05）。结论 UF‐1000i 尿沉渣分析仪与相差显微镜结合使用在血尿来源鉴别中具有重要作用。     

UF—1000i尿沉渣分析仪与相差显微镜对65例小儿血尿来源结果分析

小儿血尿原因较多,主要来源于肾脏、泌尿道。对于血尿患儿,在临床诊断与治疗过程中确定出血的部位最为关键。肾小球源性与非肾小球源性直尿的准确定位将有助于其他诊断试验的选择。目前,在临床上较为经典的鉴别血尿来源的方法,一般以相差显微镜检查尿液红细胞形态作为鉴别指标。近年来全自动尿沉渣分析仪的应用大幅提高了尿沉渣计数的准确度、精密度,节省了劳动力。并提供了尿掖中红细胞的相应参数,也可以用作评估血尿来源。     

UF-100尿沉渣分析仪鉴别血尿来源

目的　探讨UF 1 0 0尿沉渣分析仪鉴别血尿来源的临床应用价值。方法　用UF 1 0 0尿沉渣分析仪对 1 5 9例肾小球性血尿和 2 1 3例非肾小球性血尿标本进行检测 ,统计红细胞各项数据 ,并将仪器红细胞提示信息与普通光学显微镜检查结果进行比较。结果　肾小球性血尿和非肾小球性血尿标本的红细胞平均前向散射强度 (RBC MFsc)分别为 5 6 .9± 1 6 .3和 1 0 1 .7± 5 .8(P <0 .0 1 )、红细胞平均前向散射光分布宽度 (RBC Fsc DW)分别为 36 .1± 1 2 .8和 1 5 .4± 6 .2 (P <0 .0 5 )、70 %红细胞前向散射光强度 (RBC P70 Fsc)分别为 5 7.8± 1 5 .8和 1 2 1 .1± 6 .2 (P <0 .0 1 ) ;红细胞提示信息与普通光学显微镜检查结果判断肾小球性血尿的敏感性分别为93.7%和 80 .5 % ,差异有显著性 (P <0 .0 1 ) ,特异性分别为 83.1 %和 87.3% ,差异无显著性 (P >0 .0 5 )。结论　UF 1 0 0尿沉渣分析仪检测方法简便、快速 ,无主观因素干扰 ,结果敏感准确、客观可靠 ,是一种有价值的鉴别肾小球性与非肾小球性血尿的过筛试验     

全自动尿沉渣分析仪和显微镜检查对比分析

目的 分析Sysmex UF-100全自动尿沉渣分析仪(简称UF-100)检测尿液中有形成份的临床应用价值.方法 用UF-100与显微镜同时检测650例随机患者尿液,对比分析两者结果.结果 UF-100与显微镜法相比,检测红细胞阳性符合率为87.3%,阴性符合率为85.7%,假阳性率为14.3%,假阴性率为12.7%;...     

Performance of automated urine analyzers using flow cytometric and digital image-based technology in routine urinalysis

Abstract

The purpose of this study was to evaluate the analytical performances of Sysmex UF-5000 and Dirui FUS-200 and to compare the results with manual microscopy and between each other.

Two hundred fifty urine samples were analyzed for evaluation. Mid-stream specimens were studied sequentially using Dirui FUS-200 and Sysmex UF-5000, and also with manual microscopy within one hour. The physical and chemical components of urinalysis, and sediment results were investigated.

The precision results of the FUS-200 and UF-5000 for WBCs, RBCs, and ECs were acceptable. The both analyzers demonstrated good linearity (r?>?0.97), with no carry-over. The comparisons of FUS-200 and UF-5000 with manual microscopy for RBCs, WBCs, and ECs on 250 samples exhibited good agreement with little bias (R?>?0.780). Only, the moderate agreements were obtained for calcium oxalate for both analyzers (R?=?0.512, and 0.648, respectively). The sensitivities of the FUS-200 and UF-5000 were 75.8% and 86.8%, with specificities of 92.3% and 87.8% for WBCs, for RBCs the sensitivities were 91.1%, and 84.4% with specificities of 82.2%, and 89.6% for both analyzers. Kappa values of the UF-5000 were higher than FUS-200 for WBCs, RBCs, ECs, and calcium oxalate.

The FUS-200 and UF-5000 urine analyzers, are both accurate, very precise systems and can be safely used in clinical laboratories. However, due to the technological characteristics of the UF-5000 analyzer, its positive impacts on the morphologic recognition and enumeration of RBCs and WBCs should be taken into account, particularly in university hospital laboratories with high patient volumes.     

The incidence and implications of haematuria in renal colic

The aim of the study was to investigate the incidence of haematuria in patients presenting to the emergency department with renal colic, subsequently proven to be due to renal or ureteric calculus. Of 461 files reviewed, 239 satisfied the study criteria. Twenty two of these (9.2%) had no haematuria. Injectable narcotic analgesic was required in 203 of 239 cases whilst the remaining 36 patients received oral analgesic. Analysis of data from the study group as well as two other groups selected from the rejected files showed that the incidence of haematuria was the highest (91%) when patients presented with acute renal colic requiring injectable narcotic analgesic (active state) and was the lowest (47%) for patients admitted for elective management of calculi (quiescent state). Emergency intravenous urogram should be performed in patients presenting with suspected renal colic without haematuria.     

iQ200全自动尿液显微镜分析仪筛检尿路感染

目的探讨iQ200全自动尿液显微镜分析仪(简称iQ200)用于筛检尿路感染的可行性。方法214例中段尿标本在作病原体分离培养后立即用iQ200检测细菌(BACT)、小颗粒(ASP)和酵母菌(YST)等3项参数,用UF100全自动尿沉渣分析仪(简称UF100)检测细菌(BACT)和酵母菌(YLC)等2项参数。以培养结果作为金标准,应用受试者工作特征(ROC)曲线确定iQ200和UF100各项参数的最佳临床判断界值,评价各项参数的灵敏度、特异度、假阳性率、假阴性率和ROC曲线下面积。结果iQ200的BACT、ASP和YST的最佳临床判断界值分别为4.5/μl、2 404.5/μl和8.5/μl,灵敏度分别为73.3%、90.0%和90.5%,特异度为96.2%、46.9%和90.2%,假阳性率为3.3%、48.4%和8.4%,假阴性率为2.8%、0.9%和0.9%,ROC曲线下面积为0.862、0.698和0.946。UF100的BACT和YLC的最佳临床判断界值为4 657.6/μl、41.6/μl,灵敏度为76.0%、61.9%,特异度为76.8%、97.4%,假阳性率为17.8%、1.4%,假阴性率为5.6%、3.3%,ROC曲线下面积为0.821和0.795。结论iQ200用于筛检尿路真菌感染和革兰阴性杆菌感染具有一定的价值,但不能代替病原体的培养鉴定。     

UF-500i与IQ200尿沉渣分析仪检测管型的比较和评价

目的比较UF-500i与IQ200尿沉渣分析仪在检测管型中的敏感度、特异度和影响因素。方法采用UF-500i、IQ200尿沉渣分析仪和离心沉淀显微镜法分别检测门诊肾病患者晨尿标本,以人工镜检法作为标准对两种仪器敏感度、特异度进行分析。结果480份晨尿标本中,UF-500i尿沉渣分析仪敏感度为97．1％（68／70）,特异度为76．6％（314／410）;IQ200尿沉渣分析仪人工修饰前后敏感度分别为91．4％、100％（64／70,70／70）,特异度为70．5％／98．3％（289／410,403／410）。结论UF-500i与IQ200尿沉渣分析仪具有较高的管型检测灵敏度,但假阳性率高,均需人工复核以提高准确性。     

IQ200ELITE尿沉渣分析仪检测红细胞的方法学评价

目的评价IQ200 ELITE尿沉渣分析仪的性能,探讨其临床应用价值。方法使用IQ200 ELITE尿沉渣分析仪和Fast-Read尿沉渣计数板计数血细胞悬液和尿样标本中红细胞数并进行统计分析。结果 IQ200检测红细胞的线性范围大致为7~3 800,批内精密度为3.8%,批间精密度为4.7%,日间精密度为5.6%,总重复性为4.91%,携带污染率在0.00%~0.31%之间,平均0.21%,与Fast-Read尿沉渣计数板计数红细胞数比较不存在明显恒定的系统误差,但易受小圆形草酸钙的干扰。结论 IQ200具有良好的线性,较宽的线性范围,精密度较高,携带污染率极低,不存在明显恒定的系统误差,可用于过筛检查和治疗监控,具有较高的临床应用价值。     

Urine cytology is an unnecessary expense in the evaluation of adult haematuria

Patients with microscopic and macroscopic haematuria undergo a series of investigations: the upper tracts are investigated with radiological investigations, the lower urinary tract with cystoscopy; urine is sent for microscopy, culture and sensitivity and cytological analysis. The aim of this study is to evaluate the role of urine cytology in adult patients with haematuria. A total of 6060 voided urine cytology specimens obtained from adults over the age of 18 who presented with haematuria in a single centre. Of the 6060 specimens sent for analysis, 5893 (97%) were reported to be benign, and 167 (3%) were not benign. Further analysis of the non-benign results revealed 69 (41·3%) incomplete records and patients excluded. Of the 98 remaining results 34 (34·7%) were reported as repeat sample required; 44 (44·9%) were reported as suspicious for malignancy and 20 (20·4%) were reported as diagnostic. A total of 41 patients were finally diagnosed with cancer. All patients diagnosed with cancer were diagnosed on imaging or cystoscopy regardless of urine cytology result. This study has shown that urine cytology offers no unique information to adult patients being investigated for haematuria. It remains an expensive test and delays the haematuria pathway.     

尿红细胞3种检测方法的结果差异及影响因素分析

目的探讨3种方法（镜检与尿干化学法及UF-50全自动尿沉渣分析仪）测定尿红细胞结果的吻合性及其影响因素。方法采用镜检法和尿干化学法及UF-50全自动尿沉渣分析仪对同一尿液标本进行尿液红细胞测定。结果3种方法检出红细胞阳性率分别是：UF-50全自动尿沉渣分析仪法为29．4％,尿干化学法为23．2％,镜检法为21．6％。UF-50全自动尿沉渣分析仪法明显高于尿干化学法和镜检法。3种方法阳性率不尽相同,差异有统计学意义。结论3种方法测定尿红细胞结果有一定的差异,联合检测和结合临床资料综合分析才能更好地确定尿液中红细胞的有无及其来源（肾性与非肾性）。     

Clinical laboratory automated urinalysis: comparison among automated microscopy, flow cytometry, two test strips analyzers, and manual microscopic examination of the urine sediments

Urinalysis is one of the habitual clinical laboratory procedures, which implies that one of the largest sample volumes currently requires significant labor to examine microscopic sediments. Different analyzers currently used to perform this task have been compared with the manual microscopic sediment examination. The Atlas Clinitek 10 (Bayer Corporation, Diagnostics Division, Tarrytown, NY) and Urisys 2400 (Hitachi Science Systems Ltd., Ibaraki, Japan) test strips analyzers and two automated urinalysis systems, Sysmex UF-100 (Sysmex Corporation Kobe, Japan) and IRIS iQ200 (International Imaging Remote Systems, Chatsworth, CA), have been considered. We assessed the concordance between the results obtained from 652 freshly collected urine samples for erythrocytes (RBC), leukocytes (WBC), squamous epithelial cells (EC), nitrites/bacteria, and crystals using the methodologies mentioned. A principal components analysis was performed in order to examine the correlation between these parameters. Instrument accuracy was also assessed. The Spearman's statistic (p) showed an adequate agreement between methods for RBC (iQ200=0.473; UF-100=0.439; Atlas=0.525; Urisys=0.539), WBC (iQ200=0.695; UF-100=0.761; Atlas=0.684: Urisys=0.620), and bacteria/nitrites (iQ200=0.538; UF-100=0.647; Atlas=0.532; Urisys=0.561) counts. By applying the Wilcoxon and McNemar tests, a concordance degree was found between 82-99 and 52-95% for the values obtained from the two test strips analyzers considered and from the iQ200 and UF-100 systems, respectively. From these results, we can conclude that both test strips analyzers are similar and, on the other hand, that automated urinalysis is needed to improve precision and the response time; but sometimes manual microscopic revisions are required, mainly when flags, because of crystals, are detected.