张昭勇　杨宏伟　罗卉丽.湖北医药学院附属太和医院检验部，湖北十堰442000；2.湖北省十堰市妇幼保健院检验科，湖北十堰442000

Sysmex UF-1000i白细胞和细菌计数阈值的建立及其筛选尿路感染的价值

张昭勇1杨宏伟1罗卉丽2▲
1.湖北医药学院附属太和医院检验部，湖北十堰442000；2.湖北省十堰市妇幼保健院检验科，湖北十堰442000

目的运用ROC曲线法建立Sysmex UF-1000i全自动尿液分析仪白细胞和细菌计数的阈值（cut off），评估上述指标在筛选尿路感染中的临床价值。方法应用Sysmex UF-1000i全自动尿分析仪对2016年3～5月于湖北医药学院附属太和医院住院患者383份尿标本进行检测，同时做中段尿定量细菌培养。以临床诊断尿路感染的标准作为诊断尿路感染的“金标准”，绘制白细胞和细菌计数的ROC曲线，采用Z检验比较两种方法的ROC曲线下面积。结果UF-1000i全自动尿液分析仪检测白细胞数和细菌数的阈值为白细胞数71.2个/μL和细菌数171.25个/μL，以该阈值筛检尿路感染，其敏感度分别为70.21%和83.69%，特异度分别为75.21%和81.82%。白细胞计数和细菌计数ROC曲线下面积分别为0.799和0.891，经等效性检验，差异有统计学意义（P＜0.05）。结论Sysmex UF-1000i尿分析仪白细胞和细菌计数可作为临床尿路感染快速筛检的一个辅助指标，其中细菌计数较白细胞计数有更高的诊断价值。

尿路感染；Sysmex UF-1000i尿分析仪；阈值；筛查价值

［Abstract］Objective To established Sysmex UF-1000i urine flow cytometer leukocyte and bacteria count cut off value using ROC curve，then evaluate its clinical values of screening urinary tract infection.Methods 383 urine specimens in Taihe Hospital Affiliated to Hubei University of Medicine from March to May 2016 were detected by UF-1000i Urine Flow Cytometer and urine culture respectively.Clinical diagnosis of urinary tract infection standard was taken as gold standard，leukocyte and bacteria count ROC curve was drawed.Two methods area of ROC curve was compare by the Z test.Results Sysmex UF-1000i analyzer detected leukocyte and bacteria cut off value should be 71.2 WBC/μL and 171.25 bacteria/μL.This threshold was used for screening urinary tract infection，the sensitivity was 70.21%and 83.69%，specificity was 75.21%and 81.82%，respectively.Leukocyte and bacteria count area of ROC curve were 0.799 and 0.891，equivalence test result showed there was statistically significant difference（P＜0.05）.Conclusion Sysmex UF-1000i urine analyzer leukocyte and bacteria count detection are suitable screening for urinary tract infection as an auxiliary index，especially，bacteria count has higher diagnostic value than leukocyte count.

［Key words］Urinary tract infection；Sysmex UF-1000i urine flow cytometer；Cut off value；Screening value

尿路感染是临床最常见的感染性疾病之一，目前的实验室诊断方法主要包括中段尿定量培养、尿沉渣的白细胞和细菌计数检测及干化学的白细胞酯酶和亚硝酸盐的检测。上述方法都有自己的优缺点，其中中段尿定量培养被称为实验室诊断的“金标准”，但是该法费时费力，通常需要3～4 d才能获得检验结果，不利于尿路感染的快速早期诊断；……