基于不同方法对尿液红细胞检测的比对与疾病符合程度分析

目的采用尿干化学分析仪、尿沉渣分析仪检测尿液红细胞,人工显微镜复检,对结果进行比对分析,同时进行疾病的符合程度分析。方法随机收集1233例临床患者新鲜中段尿液标本,采用尿干化学分析仪、尿沉渣分析仪,分别对尿液中的红细胞进行检测,用显微镜进行人工复检,并对结果进行比对分析,同时进行疾病的符合程度分析。结果尿干化学法检测红细胞阳性符合率为89.13%,阴性符合率为98.11%,假阴性率为10.87%,假阳性率为1.89%。尿沉渣自动分析仪法检测红细胞阳性符合率为79.79%,阴性符合率为98.47%,假阴性率为20.21%,假阳性率为1.53%。各年龄组三种方法检测结果显示,60岁以上年龄段组干化学法阳性率为40.63%、尿沉渣仪法阳性率为42.77%、显微镜复检法阳性率为40.21%,显著高于其他年龄段组别。性别分组不同的三种方法检测结果显示,男性组干化学法阳性率为41.07%、尿沉渣仪法阳性率为37.95%、显微镜复检阳性率为38.62%,而女性组干化学法阳性率为58.93%、尿沉渣仪法阳性率为62.05%、女性组显微镜复检阳性率为61.38%。由此可见女性组阳性率均显著高于男性组阳性率。差异有统计学意义(P<0.05)。结论使用尿干化学分析仪、尿沉渣分析仪法检测尿液中的红细胞存在假阳性和假阴性的结果,需要结合显微镜进行人工复检,才能提高检验的准确率,更好地服务于临床。     

Sysmex UF-100尿沉渣分析仪检测尿中红细胞的准确性的探讨

目的探讨UF-100尿沉渣分析仪检测尿中红细胞的准确性及其影响因素. 方法随机收集住院及门诊患者的晨尿标本,先用UF-100尿沉渣分析仪自动进样模式检测,后再将标本离心取沉渣于显微镜下镜检.将两种方法检测的结果作比较.结果UF-100尿沉渣分析仪检测1102例,阳性率占40.8%.显微镜下镜检红细胞阳性率占23.8%,其中假阳性率20.67为%,假阴性率占7.42%.结论UF-100尿沉渣分析仪对尿中红细胞的检测存在较高的假阳性率.对UF-100尿沉渣分析仪检测红细胞阳性的标本仍需用显微镜进行复检,两种方法必须结合在一起才能正确的判断一个标本是否为红细胞阳性的根据.     

UF-1000i尿沉渣分析仪与显微镜检测尿液红细胞、白细胞结果比较

目的 对UF-1000i尿沉渣分析仪与显微镜检测尿中红细胞、白细胞的结果进行比较,探讨UF-1000i尿沉渣分析仪临床应用价值.方法 收集1085例尿液样本,分别进行UF-1000i尿沉渣分析仪与显微镜检测.结果 UF-1000i尿沉渣分析仪与显微镜检测结果比较,红细胞的阳性符合率91.87%,假阳性率15.58%,阴性符合率84.41%,假阴性率8.12%;白细胞的阳性符合率92.70%,假阳性率12.46%,阴性符合率87.53%,假阴性率7.30%.两组检测结果分别做配对资料χ2检验,均无显著差异.结论 UF-1000i尿沉渣分析仪自动化程度高,与显微镜检测结果符合率良好,但受干扰因素较多,对结果异常者仍需用显微镜复检,以提高报告结果的准确性,为临床诊断、治疗提供有价值的信息.     

尿液分析系统智能审核规则的建立与临床验证

目的 利用人工智能的方法建立尿液分析系统自动审核规则,并且优化后用于临床评价。方法 收集北京首都医科大学附属朝阳医院2022年7月至2023年6月的尿液标本16 000例,阳性标本(尿干化学及尿沉渣结果任何一项出现阳性的标本)4 889例,以及阴性标本(尿干化学及尿沉渣结果均为阴性)11 111例。进行第一次方法训练,得到一组自动审核规则及方法A,评价其预测性能。所有标本均经显微镜镜检复核,结合临床患者基本信息、尿干化学、尿沉渣以及显微镜检测结果,均一致的标本标记为阴性通过,反之标记为阳性拦截。经统计,被拦截的标本为786例,将这786例标本作为重点样本组,其余的阳性标本为非重点样本组,进行第二次方法训练,得出最终自动审核的规则及方法B,并评价其预测性能。对两次预测结果进行判断(包括假阴性率、假阳性率、真阴性率、真阳性率),同时计算其诊断效能指标(包括放行率、阳性预测值、阴性预测值、总有效率、特异性、灵敏度、重点病例覆盖率等)。结果 方法B得到了71条自动规则,自动审核放行率达到51.8%,假阳性率为26.9%,假阴性率控制在3.3%,并且覆盖了99.5%的重点病例。结论 本研究建立的...     

IQ-200全自动尿沉渣分析仪管型检测评价

目的评价IQ-200全自动尿沉渣分析仪管型检测的准确性.方法选择300例干化学法尿蛋白+及以上的住院患者晨尿标本,同时采用IQ-200全自动尿沉渣分析仪和离心沉淀显微镜镜检法检查管型.结果 300例晨尿标本中IQ-200全自动尿沉渣分析仪提示存在管型的为148例,经人工修饰后为51例;显微镜检查阳性为68例.结论 IQ-200全自动尿沉渣分析仪管型检测假阳性率较高,人工修饰可显著提高其准确性.     

多种检测方法对尿液中红细胞测定结果的对比分析

目的 强调在使用尿干化学分析仪和全自动沉渣仪常规检测红细胞时显微镜检查的重要性.方法 随机收集患者新鲜晨尿800例,分别使用显微镜检查、干化学分析仪和全自动尿沉渣分析仪检测,比较三种方法红细胞的检测结果.结果 干化学分析仪法红细胞阳性率31.3％,尿沉渣仪法红细胞阳性率27.0％,尿沉渣镜检红细胞阳性率为21.0％,结论 干化学法和沉渣分析仪法在检测尿液红细胞时均出现一定的假阳性分别为10.6％和9.0％和假阴性分别为2.7％和2.5％,因此,当红细胞结果出现异常,就必须对异常标本依据显微镜检查的标准化程序进行显微镜检查以确诊,力争为临床提供更准确的检验结果,避免造成误诊误治.     

血涂片分析在血常规检验中的重要性探析

目的：对血涂片分析在血常规检验中的重要性进行分析探讨,为今后的临床检验工作提供可靠的参考依据。方法抽取在2013年1月~2013年12月我院收治的需接受血常规检验的临床患者98例和同期健康体检者98例,对其进行血常规检查,对比分析检验结果。结果临床患者血标本经血涂片检查正常者46例,假阳性率为46.94%;正常组血涂片检查异常者1例,假阴性率为1.02%。结论血涂片镜检工作可使疾病的诊断准确率得到显著提高,值得临床对其给予关注。     

UF-1000i尿沉渣检测结果与临床诊断的符合性分析

目的：探讨UF-1000i尿沉渣检测结果与临床诊断结果之间的符合性。方法收集2013年1月~2014年5月我院收治的血尿以及泌尿系统感染患者80例,采用U F-1000i进行尿沉渣检验,并与临床诊断结果进行比较。结果 UF-1000i尿沉渣检测对泌尿系统感染的符合率为85.71%,对血尿的诊断符合率为85.71%。结论 UF-1000i尿沉渣检测结果对于泌尿系统感染的具有较高的诊断效能,操作简便快速,具有较高的临床应用价值。     

探讨尿干化学法检查尿潜血和离心尿液显微镜法检查尿红细胞在临床中的应用

目的：通过对尿干化学法检测尿潜血和离心尿液显微镜法检查尿红细胞这两种检验方法进行比较和分析，探讨这两种检验方法在临床中的应用价值。方法随机选取2013年4月~2014年4月1年间400例门诊患者的尿标本，按照尿液分析仪(尿干化学法)和离心尿液显微镜法检查的标准操作规程对尿标本进行红细胞检测。结果400例尿液标本中尿液分析仪检测阳性结果123例，其中镜检红细胞为阳性结果的有108例，镜检红细胞为阴性结果的有15例，假阳性率为12.2%，尿液分析仪检测阴性结果277例，镜检红细胞为阴性结果的有269例，镜检红细胞为阳性结果的有8例，假阴性率为2.9%，两种检测方法的结果有差异。结论在临床工作中尿液红细胞(尿潜血)检查最好用尿干化学法检测和离心尿液显微镜法检查相结合的方法，能有效避免假阴性和假阳性，提高准确性，避免误诊和漏诊。     

细胞蜡块在乳腺肿块细针穿刺细胞学中的应用

目的探讨细胞蜡块(cell block,CB)技术在乳腺肿块细胞学诊断中的应用价值。方法对327例乳腺肿块患者行细针穿刺细胞学(fine needle aspiration cytololgy,FNAC)检查,并制作CB,与术后组织学病理诊断结果进行对比分析。结果经组织病理学对照,FNAC诊断敏感度为95.96%,特异度为96.12%,假阳性率为3.88%,假阴性率为4.04%,阳性预示值为97.44%,阴性预示值为93.94%,诊断准确率为96.02%。CB联合FNAC诊断敏感度为97.98%,特异度为98.45%,假阳性率为1.55%,假阴性率为2.02%,阳性预示值为98.98%,阴性预示值为96.95%,诊断准确率为98.17%。结论 CB可以弥补FNAC的不足,CB联合FNAC检测可有效提高诊断敏感度、特异度及准确率。     

Mandatory use of confirmation stage with Chlamydiazyme during urinary sediment analysis.

AIMS--To assess whether false positive results found when the first stage Chlamydiazyme test is performed on urinary sediment could be reduced by using the more specific second stage blocking assay. METHODS--Sediment from 173 urine samples from patients with suspected urinary tract infection caused by Gram negative bacteria and 23 control urine samples were tested using the Chlamydiazyme assay system, which included a blocking assay. RESULTS--A reaction result with the first stage Chlamydiazyme assay test was seen in 102 (58.9%) of the test urine samples. First stage reactivity was not blocked by the Chlamydiazyme confirmatory assay performed on repeat testing. All were correctly identified as true negative (first test false positive) results. CONCLUSIONS--Use of a second (specific) blocking assay for the analysis of urinary sediment using Chlamydiazyme eliminates false positive results in Gram negative urinary tract infections.     

甘肃省甘南地区儿童尿液筛查结果及影响因素分析

目的 分析儿童尿常规筛查各指标阳性率分布及其影响因素,早期防治儿童肾脏病。方法 采用多级抽样方法,于2017年8月~9月选取甘肃省甘南地区托幼机构、小学及各乡镇未入托0~10岁儿童为研究对象,进行尿常规检测结果进行统计分析,了解甘南高原地区儿童尿检异常情况及影响因素的差异。结果 多数父母对于儿童肾脏病的知晓率较低,对于孩子肾脏情况关注度不高;尿常规总阳性检出率为40.60%,各指标检出率从高到低依次为维生素C、尿酮体、尿白细胞、尿潜血,阳性检出率分别为12.00%、11.75%、7.70%、5.27%,血尿+蛋白尿为 0.40% 。尿潜血阳性及阴性儿童在民族、是否憋尿、清洗外阴频次比较,差异有统计学意义（P＜0.05）;尿蛋白阳性及阴性儿童在民族、洗澡及摄入粗粮频次比较,差异有统计学意义（P＜0.05）;尿白细胞阳性及阴性在性别、民族、饮水种类、换洗内裤频次、收入比较,差异有统计学意义（P＜0.05）;Logistic回归显示,油炸食品、每天吃甜食是尿检潜血阳性危险因素,洗澡是其保护因素,男性、汉族、饮用纯净水是尿白细胞的保护因素（P＜0.05）;结论 组织甘南地区的肾脏病宣教活动,加强教育及医疗资源投入;蔬菜、水果、甜食等摄入需适量,减少含铅食品摄入,避免儿童暴露于吸烟及污染环境,注意环境及个人卫生有利于儿童肾脏病防治。     

Clinical usefulness of cervicogram as a primary screening test for cervical neoplasia

The purpose of this study is to evaluate the clinical usefulness of the cervicogram as a primary screening test for cervical neoplasia. A total of 294 women who had undergone a cervicogram and a Pap test between January and July 2003, were selected. The diagnostic accuracy of the Pap test, cervicogram, and the Pap test combined with a cervicogram were compared with the histopathologic diagnosis. Among 294 women, the Pap test was negative in 130 cases and positive in 164 cases. Among patients with positive Pap test, cervicogram were negative in 101 cases (61.6%) and positive in 63 cases (38.4%). The diagnostic accuracy between cervicogram with positive Pap test and histology was as follows; sensitivity 44.9%, specificity 78.3%, positive predictive value 84.1%, negative predictive value 32.7%, false positive rate 15.9%, and false negative rate 67.3%. Although the adjunctive use of cervicogram with the Pap test in the initial screening of cervical neoplasia showed a higher specificity and higher positive predictive value compared to the Pap test alone, consideration in terms of lower sensitivity, lower positive predictive value, higher false positive rate and cost-effectiveness should be given in lieu of clinically applying cervicogram with the pap test as an initial screening test.     

随机尿微量白蛋白/肌酐比值的半定量试纸条法的临床评价

目的 评价半定量试纸条法检测随机尿微量白蛋白/肌酐比值(ACR)方法学性能.方法 选取2016年12月至2018年3月2288份随机尿标本,分别通过全自动生化分析仪和半定量试纸条法检测ACR,分析比较两种方法学检测结果的差异.结果 半定量试纸条法检测方法与全自动生化分析仪定量检测方法之间成正相关(r =0.577,P＜0.01).半定量试纸条检测法的灵敏度为90.7％,特异性为66.7％.假阳性率为37.0％,假阴性率为8.3％.结论 半定量试纸条法存在假阳性率和假阴性率,可结合定量方法作为一种筛查方法.     

尿肾功检测在早期糖尿病肾病诊断中的应用分析

目的 分析尿肾功检测在早期糖尿病肾病（DN）诊断中的应用价值。方法 选择2017年5月~2018年5月我院收治的100例DN患者为研究对象,设为为观察组。另选取同期来我院行健康体检者的100名健康者设为对照组,比较两组尿肾功检各项指标,包括mALB、UCr、N-AG、β2-MG以及mALB/UCr比值。结果 观察组受试者的mALB、UCr、N-AG、β2-MG以及mALB/UCr比值均高于对照组,差异有统计学意义（P＜0.05）;尿肾功检测诊断早期糖尿病肾病的阴性预测值、阳性预测值、准确度、特异度以及灵敏度分别为94.81%、87.21%,90.13%,81.94%以及96.54%。结论 尿肾功检测法,用于早期糖尿病肾病诊断,其准确性及特异性均较高。     

UF-100尿沉渣分析仪提示红细胞信息的结果分析

目的探讨UF-100尿沉渣分析仪提示红细胞信息的临床意义。方法用UF-100尿沉渣分析仪、DIRUIH-300干化学分析仪、离心沉渣镜检3种方法对880例新鲜尿红细胞进行检测,统计红细胞荧光参数并比较。结果UF-100尿沉渣分析仪红细胞检出率为56.36%,红细胞信息(RBC-Info)提示率为53.02%,其中正常红细胞(Normocytic)比率占28.52%,与离心沉渣镜检符合率为100%;小红细胞(Microcytic)比率占16.35%,与离心沉渣镜检符合率为97.67%;混合红细胞(Non-classifide)比率占55.13%,与离心沉渣镜检符合率为46.21%。结论UF-100尿沉渣分析仪、干化学分析、离心沉渣镜检联合检测是鉴别血尿来源的可靠方法,UF-100红细胞信息提示易受干扰,不能完全替代镜检。     

Urinary hydatid antigen detection by coagglutination, a cost-effective and rapid test for diagnosis of cystic echinococcosis in a rural or field setting

We describe here coagglutination (Co-A), a rapid slide agglutination test for the detection of hydatid antigen in the urine for the diagnosis of cystic echinococcosis (CE). Paired urine and serum samples were collected from 16 patients with surgically confirmed CE, 10 patients with ultrasound-proven CE, 14 patients with clinically diagnosed CE, 24 patients with various parasitic diseases other than CE, and 25 healthy control subjects. Co-A detected excreted hydatid antigen in the concentrated urine of 7 of 16 (43.75%) surgically confirmed cases, 6 of 10 (60%) ultrasound-proven cases, and 8 of 14 (57.14%) clinically diagnosed cases of CE. A false-positive reaction was observed with 12.50% of control urine specimens from patients with parasitic diseases other than CE and 12% of urine samples from healthy controls. The circulating antigen was detected in the serum in 13 of 16 (81.25%) surgically confirmed cases, 6 of 10 (60%) ultrasound-proven cases, and 13 of 14 (92.86%) clinically diagnosed cases of CE. False-positive reactions were observed with three sera (12.5%) from controls with other parasitic diseases. The low sensitivity of Co-A for detection of antigen in the urine of a patient whose serum was positive for the antigen is possibly due to low levels of antigen in the urine. Unlike the collection of blood for serum, which is an invasive procedure and also requires technical expertise and disposable syringes, urine can be collected easily and frequently without causing any inconvenience to the patient. Urine as a clinical specimen alternative to serum would be immensely useful in the diagnosis of CE, particularly in a rural or field setting. In such situations as well as in poorly equipped laboratories, Co-A has the potential to be used as a simple, rapid, and economical slide agglutination test for detection of urinary hydatid antigen in the diagnosis of CE.     

有核红细胞采用XN1000血液分析仪计数与人工计数结果比较

目的 Sysmex XN1000b型全自动血细胞分析仪检测的有核红细胞结果的有效性和准确性,通过金标法人工涂片检测进行验证。方法 2017年1月~2017年3月本院经过Sysmex XN1000b型全自动血细胞分析仪检测有核红细胞结果阳性标本213例进行仪器结果与人工涂片结果进行准确性验证,对随机抽取100例有核红细胞结果为零的标本验证阴性符合率验证。结果 采用Sysmex XN1000b型全自动血细胞分析仪计数有核红细胞,真阳性率100.00%,假阳性率2.09%,假阴性率0（＜5%）,真阴性率96.70%,阳性结果符合率97.56%。结论 Sysmex XN1000b型全自动血细胞分析仪检测的有核红细胞计数准确性高,阴阳性符合率好,结果可靠,有核红细胞计数可以作为临床报告项目。     

不同尿沉渣检测方法在检测尿红细胞形态及参数中的价值分析

目的 探究全自动尿沉渣分析仪联合尿干化学分析法在尿沉渣检测中的价值.方法 随机选取118份从住院患者处收集的血尿样本,根据临床诊断结果将其分为肾小球疾病组(肾小球性血尿组,n =72)及非肾小球疾病组(非肾小球性血尿组,n=46).比较两组血尿样本尿平均红细胞体积(MCV)、尿平均红细胞血红蛋白(MCH)水平差异.每份尿样均分为2管(15mL/管),分别予以显微镜人工镜检法及全自动尿沉渣分析仪+尿干化学检测法检测(尿液收集后2h内完成).记录两种检测方法的尿红细胞(RBC)阳性检出率;以临床诊断结果为依据评估其尿RBC形态参数测定结果差异.结果 肾小球性血尿组患者尿MCV、尿MCH水平均明显低于非肾小球性血尿组患者,差异有统计学意义(P＜0.05).118份血尿样本经全自动尿沉渣分析仪+尿干化学检测法测得尿RBC阳性率为76.3％ (90/118),显微镜人工镜检法测得尿RBC阳性率75.4％ (89/118);两组尿RBC阳性检出率比较,差异无统计学意义(P＞0.05).显微镜人工镜检法鉴别灵敏度为97.2％(70/72)、特异性为84.8％ (39/46);全自动尿沉渣分析仪+尿干化学检测法鉴别灵敏度为94.4％ (68/72)、特异性为80.4％(37/46),两种方法灵敏度及特异性比较,差异无统计学意义(P均＞0.05).结论 全自动尿沉渣分析仪+尿干化学检测法对血尿来源的定位诊断准确性较高且操作性强,临床可将其作为一种可行性途径,为后续治疗工作的顺利开展提供依据.     

Diagnosis by AMPLICOR PCR of Chlamydia trachomatis infection in urine samples from women and men attending sexually transmitted disease clinics.

Screening of urine specimens from men for Chlamydia trachomatis infection by a commercial PCR assay (AMPLICOR C. trachomatis Test; Roche Diagnostic Systems, Inc., Branchburg, N.J.) is a sensitive and specific noninvasive diagnostic assay. Since screening of women for C. trachomatis infection with the AMPLICOR C. trachomatis Test has been limited to use with endocervical swab specimens, we conducted an evaluation of the AMPLICOR C. trachomatis Test for the detection of C. trachomatis using female urine samples and compared the results of those obtained by in vitro culture and PCR of endocervical swab specimens. For 713 men we compared the performance of AMPLICOR C. trachomatis Test with urine specimens with that of culture of urethral specimens. For specimens that were PCR positive and culture negative, two additional tests were used to resolve the discrepancies: direct fluorescent-antibody assay (DFA) of sediment from a spun endocervical specimen culture vial and major outer membrane protein-based PCR of the sediment from the endocervical specimen culture vial. Of 525 urine specimens from females, 67 (12.8%) were PCR positive, and 41 (7.8%) endocervical specimens from the 525 women were culture positive. After resolution of the discrepancies, the resolved sensitivity of the urine PCR was 93.3%, whereas the sensitivity of endocervical swab specimen culture was 67.3%. Of 468 female endocervical swab specimens, 47 (10.0%) had a positive PCR result and 33 (7.0%) were culture positive. The resolved sensitivity of the endocervical swab specimen PCR was 86%. Of 415 matched female urine and endocervical swab specimens, there were 49 confirmed infections; 30 (61.2%) specimens were positive by culture of the endocervical swab specimen, 40 (81.6%) were positive by confirmed endocervical swab specimen PCR, 43 (87.8%) were positive by confirmed urine PCR, and all 49 (100%) were positive by either endocervical swab specimen PCR or urine PCR. For men, the resolved sensitivity of the urine PCR was 88%, and the sensitivity of culture was only 50.7%. These results indicate that urine PCR is highly sensitive for the detection of C. trachomatis in both women and men and provides a noninvasive technique for routine screening for chlamydial infection.