EH2060与UF-50尿沉渣分析仪检测管型的结果评价

【目的】以显微镜检测为金标准，评价EH2060、UF-50尿沉渣分析仪检测尿中管型的灵敏度及特异度，并提出尿管型检测新流程。【方法】以尿蛋白水平将540例肾内科患者分为5组，以镜检法及仪器法（EH2060及UF-50）分别检测患者的尿液管型，并以镜检法检测结果为金标准，在不同尿蛋白水平下，评价仪器法结果的灵敏度及特异度。【结果】在各尿蛋白水平下，UF-50法阳性率皆高于镜检法（尿蛋白为“±”组P〉0．05，其余组P〈0．01）；而EH2060法的阳性率在各尿蛋白水平下皆低于镜检法（尿蛋白为“-”、“±”组P〉0．05，其余组P〈0．01）；EH2060特异度高（100％）而灵敏度较低（45．22％），而UF-50灵敏度较高（93．63％）而特异度较低（71．88％）；按照检测新流程进行检测，灵敏度可提高至95％以上，特异度接近100％。【结论】EH2060存在较高的漏诊率，而UF-50存在较高的误诊率，两种仪器皆无法完全替代镜检法。须以仪器法及镜检法联合使用以提高临床尿管型检测的准确性。笔者建议：先用EH2060检测，如EH2060检测阳性即为真阳性结果，如为阴性再用UF50检测，如UF50检测阴性，则基本可以认定为真阴性，如UF-50检测结果为阳性，则须再结合显微镜尿沉渣镜检。

Evaluation of the Result of Urinary Sediment Analyzer EH2060 and UF-50 for the Detection of Urinary Cast

Objective]To investigate the sensitivity and specificity of urinary sediment analyzer EH2060 and UF-50 for the detection of urinary cast on the basis of the microscopic examination as golden standard and to propose the new process for detecting the urinary detection. Methods] A total of 540 patients who suffered from kidney disease were divided into 5 groups by urine protein level. EH2060 and UF50 analyzers and manual method by microscopic examination were adopted to detect urinary cast of patients respectively. Then, the sensitivity and specificity of the analyzers were evaluated on different urine protein level. Results]On each protein level, the positive rate of UF-50 was higher than that of manual method （ for the group with urine protein level as ±, P 〉0.05, the remains, P〈 0.01）, while the positive rate of EH2060 was lower than that of manual method for each level （for the group with urine protein level as - or ±,P 〉0. 05, the remains, P 〈0. 01）. The specificity of EH2060 was higher（100%）, while its sensitivity was relatively lower（45.22%）. For UF50, it was of higher sensitivity （93. 63%） and lower specificity （71.88 %）. And the results of new process showed that the sensitivity surpassed 95 %, while the specificity approached 100%. Conclusion]EH2060 has the disadvantages of higher rate of missed diagnosis, while UF-50 has higher misdiagnosis rate. Therefore, the two analyzers can not completely replace microscopic examination. Analyzer and manual method should be combined together so as to improve the accuracy for detecting the urinary cast. So a new urinary cast detection process is proposed as follows： EH2060 should be used firstly. If it comes to positive result, then it will be truly positive, while if it comes to negative result, then UF-50 should be proposed for further detection. If the current result is negative, then we consider the result is truly negative, otherwise, the sample is required to be tested by manual method with microscope.