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目的探讨相差显微镜人工镜检法对尿液红细胞(RBC)形态参数不同判定标准判断血尿来源的诊断效能。方法296例血尿标本来自北京协和医院患者,采用相差显微镜人工镜检法和UF1000i分析法进行分析,以临床诊断作为参考,评价2种方法的临床诊断效能,同时确立镜检法异常红细胞判断肾小球性血尿的最佳界值。结果针对不同异常红细胞比例(10%~90%)判定肾小球来源血尿,以镜下血尿中含有80%以上形态异常的RBC定义为肾小球性血尿时,相差显微镜人工镜检法诊断效能最佳,灵敏度为82%,特异度为81%,约登指数为63%,诊断效率为81%,ROC曲线下面积(AUC)为0.815。UF1000i分析法的灵敏度为70.3%,特异度为53.0%,约登指数为22.3%,诊断效率为60.5%,AUC为0.762。结论相差显微镜人工镜检法较自动化尿液有形成分分析仪UF1000i具有更高的临床诊断效能,其判断肾小球性血尿的最佳诊断界值点为80%。
Objective To investigate the diagnostic efficacy of phase contrast microscopy (MIA) microscopy in judging the origin of hematuria by using different judgment criteria of urinary RBC (erythrocyte) morphology parameters. Methods A total of 296 cases of hematuria from Beijing Union Medical College Hospital were analyzed by phase contrast microscopy and UF1000i analysis. The clinical diagnosis was used as a reference to evaluate the clinical diagnostic efficacy of the two methods. At the same time, abnormal erythrocytes Best hematuria threshold. Results According to the ratio of abnormal erythrocytes (10% -90%), the glomerular origin hematuria was determined. When the RBC with more than 80% morphologic abnormalities in microscopic hematuria was defined as glomerular hematuria, phase contrast microscopy was used to diagnose the effect The best, with a sensitivity of 82%, a specificity of 81%, a Youden index of 63%, a diagnostic efficiency of 81%, and an area under the ROC curve (AUC) of 0.815. The UF1000i assay has a sensitivity of 70.3%, a specificity of 53.0%, a Youden index of 22.3%, a diagnostic efficiency of 60.5%, and an AUC of 0.762. Conclusions Phase contrast microscopy is more effective than automated urine composition analyzer UF1000i in diagnosing glomerular hematuria. The best diagnostic cutoff point for determining glomerular hematuria is 80%.