摘要
目的探讨尿移行上皮细胞在膀胱炎和肾盂肾炎鉴别诊断中的应用价值。方法应用普通光学显微镜对156例泌尿系感染的尿沉渣标本进行分析[取患者中段尿10ml于无菌试管中送捡，400×g离心5min，剩余沉淀0．2ml，混匀后吸沉淀物20ul，滴在波片上，用18mm×18mm盖玻片覆盖后显微镜检查，先用10×10低倍镜观察图片，后用10×40高倍镜仔细观察细胞，检查20个视野]，探讨表层移行上皮细胞，中、底层移行上皮细胞对膀胱炎、肾盂肾炎的诊断与临床诊断结果进行对比分析，判断其符合情况。以临床诊断作为标准，计算尿沉渣检测结果对膀胱炎和肾孟肾炎诊断的灵敏度、特异度、阳性预测值、阴性预测值和准确度。结果以白细胞〉5／HP、红细胞〉3／HP、移行上皮细胞〉3／HP为阳性，对156例尿沉渣标本结果与临床诊断相比较进行分析，表层移行上皮细胞对膀胱炎的诊断（x2=2．5，P〉0．05）及中、底层移行上皮细胞对肾孟肾炎的诊断（x2=0．1，P〉0．05），差异无统计学意义。表层移行上皮细胞对膀胱炎的诊断灵敏度为80．0％，特异度为98．3％，阳性预测值为94．1％，阴性预测值为93．4％，准确度为93．6％，中、底层移行上皮细胞对肾孟肾炎的诊断灵敏度为78．3％，特异度为96．2％，阳性预测值为78．3％，阴性预测值为96．2％，准确度为93．6％，与临床诊断有很好的符合率。结论尿沉渣是泌尿系感染检查的重要检测手段，尤其是移行上皮细胞对膀胱炎和肾盂肾炎鉴别诊断有非常好的应用价值。
Objective To investigate the application value of urinary transitional epithelium in the differential diagnosis between cystitis and pyelonephritis. Methods 156 urinary sediment specimens were analysed using ordinary optical microscope E Took patient urine 10ml in a sterile tube,400 ×g centrifugal 5 minutes remaining 0. 2 ml sediment, sucking 20 ul in slide after mixing,and microscopic examination using 18 mm× 18 mm coverslip coverage. Firstly, observe the picture with a low magnification and secondly observed 20 visions by high magnification]. These detection results were collected for evaluation of the superficial transitional epithelial cell in the cystitis diagnosis and the middle, underlying transitional epithelial cell in the pyelonephritis diagnosis. The consistency were analyzed between urinary sediment results and clinical diagnosis. The sensitivity,specificity, positive predictive value,negative predictive value and accuracy rate of urinary sediment results for cystitis and pyelonephritis were evaluated for standard to clinical diagnosis. Results The statistical results from 156 urinary sediment specimens showed that the superficial transitional epithelial cell in the cystitis diagnosis （X2 = 2.5, P〉0. 05） and the middle, underlying transitional epithelial cell in the pyelonephritis diagnosis （x2 = 0. 1, P〉0. 05） were not significant statistical difference. The superficial epithelial cell microscopic examination results in the cystitis diagnosis showed the sensitivity 94. 1 %, specificity 93.4%, positive predictive value 80.0%, negative predictive value 98. 3% and accuracy rate 93.6 %, the middle, underlying transitional epithelial cell microscopic examination results in the pyelonephritis diagnosis showed the sensitivity 78. 3%, specificity 96.2%, positive predictive value 78.3%, negative predictive value 96.2% and accuracy rate 93. 6 %. Results judging standard ： WBC〉 5 / H P, RBC〉 3 / HP, transitional epithelium cell was greater than 3 / HP. Conclusion Urinary sediment examination is very important way for the diagnosis of urinary system infection. Especially there are obvious the value of application for the the differential diagnosis betweencystitis and pyelonephritis.
出处
《现代检验医学杂志》
CAS
2012年第1期85-87,共3页
Journal of Modern Laboratory Medicine
关键词
泌尿系感染
移行上皮细胞
尿沉渣
显微镜检查
urinary tract infection
transitional epithelium cell
urinary sediment
examination under the microscope
