The clinical evaluation and optimization of alarm Threshold setting for Sysmex UF5000 UTI
Received date: 2019-12-12
Online published: 2020-04-25
目的:评价尿路感染(urinary tract infection,UTI)报警信息辅助诊断临床UTI的应用价值。方法:用尿沉渣分析仪检测2 871例尿液标本,以临床诊断UTI为金标准,分析在默认设定值时仪器报警信息的诊断符合率、灵敏度和特异度。更改白细胞计数(white blood cell, WBC)和细菌计数(bacterial count, BACT)阈值,找到符合本院临床实际情况的最佳阈值,并验证其与临床诊断的符合情况。结果:以临床诊断UTI为金标准,仪器UTI报警信息的符合率为70.61%。在超过默认设定值(WBC>10个/μL和BACT>10个/μL)时,WBC的诊断灵敏度为94.23%,特异度为58.02%;BACT的诊断灵敏度为94.12%,特异度为68.98%;仪器UTI报警信息的诊断灵敏度为94.23%,诊断特异度为70.61%。由受试者操作特征曲线获得WBC和BACT 的最佳临界值分别为24.9个/μL和1 157.3个/μL,WBC和BACT诊断UTI的灵敏度取95%,特异度最高(WBC 56.8%,BACT 57.01%)时对应的值分别为26.7个/μL和60.1个/μL。经验证,当阈值设置为WBC 26.7个/μL和BACT 1 157.3个/μL时,仪器UTI报警信息的灵敏度、特异度最佳(灵敏度为93.34%,特异度为71.17%)。结论:调整阈值后,仪器的UTI报警信息有较高的诊断灵敏度和特异度,符合我院UTI早期诊断要求,可用于临床UTI的快速诊断。
陈辰, 张月, 胡晓波 . 尿路感染报警信息阈值设置和临床应用评价[J]. 诊断学理论与实践, 2020 , 19(02) : 168 -171 . DOI: 10.16150/j.1671-2870.2020.02.013
Objective: To explore and optimize the settings of alarm in Sysmex UF5000 urinary tract infection (UTI) system to assist the diagnosis of UTI. Methods: A total of 2 871 urine samples were collected and tested by Sysmex UF5000 urine sediment analyzer. The diagnostic accurate rate, sensitivity, and specificity of the default alarm threshold settings of the instrument for UTI were calculated regarding to the clinical diagnosis of UTI. The thresholds of white blood cell count (WBC) and bacterial count (BACT) were optimized to meet the local hospital need. Results: The accurate rate of instrumental alarm settings for diagnosing UTI was 70.61%, with a sensitivity of 94.23% and specificity of 70.61%. At the default setting, the diagnostic sensitivities of WBC (WBC>10/μL) and BACT (BACT>10/μL) were 94.23% and 94.12%, while specificities were 58.02% and 68.98%. The optimal cutoff values for WBC and BACT determined by ROC curve were 24.9/μL and 1 157.3/μL, respectively. However, when sensitivities of WBC and BACT were set as 95%, the specificities of both parameters were 56.8% and 57.01%, yielding the cut-off values as 26.7/μL and 60.1/μL, respectively. Clinical validation showed that best sensitivity and specificity of the system was achieved(sensitivity 93.34%, specificity 71.17%) when the WBC and BACT were reset at 26.7/μL and 1 157.3/μL, respectively. Conclusion: Optimized the alarm threshold of the Sysmex UF5000 achieve higher sensitivity and specificity, assisting rapid diagnosis of clinical UTI.
[1] | Choe H S, Lee S J, Yang S S, et al. Summary of the UAA-AAUS guidelines for urinary tract infections[J]. Int J Urol, 2018, 25(3):175-185. |
[2] | 陈瑾, 李荣亨. 尿路感染的诊治进展[J]. 中国中西医结合肾病杂志, 2003, 4(11):676-677. |
[3] | Nicolle LE. Urinary tract infection[J]. Crit Care Clin, 2013, 29(3):699-715. |
[4] | 余毅. 泌尿系统常见的医院感染及其控制[J]. 实用医学杂志, 2002, 18(1):13-14. |
[5] | 殷琳, 喻华, 乔宁, 等. 四川省细菌耐药监测网2011-2012年尿路感染病原菌分布及耐药分析[J]. 国际检验医学杂志, 2014, 22:3019-3021,3024. |
[6] | 中国女医师协会肾脏病与血液净化专委会. 中国女性尿路感染诊疗专家共识[J]. 中华医学杂志, 2017, 97(36):2827-2832. |
[7] | 尿路感染诊断与治疗中国专家共识编写组. 尿路感染诊断与治疗中国专家共识(2015版)——复杂性尿路感染[J]. 中华泌尿外科杂志, 2015, 36(4):241-244. |
[8] | 黄伟文, 王芳. 尿路感染的实验室诊断进展[J]. 当代医学, 2015(8):17-18,19. |
[9] | 张全贵. 尿路感染的治疗进展[J]. 国外医学:泌尿系统分册(4期):152-155. |
[10] | 王燕凤, 赖小华, 黄印翔. Sysmex UF5000全自动尿液有形成分分析仪的主要性能研究[J]. 医学理论与实践, 2018, 31(22):115-117. |
[11] | 张昭勇, 杨宏伟, 罗卉丽. 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[J]. 中国医药导报, 2016, 13(25):142-145. |
[12] | 徐树. 尿沉渣白细胞及细菌定量计数联合检测与尿细菌培养诊断尿路感染的比较[J]. 现代养生B, 2014, 4:139. |
[13] | 罗岚, 何超, 李冬冬, 等. UF-1000i尿沉渣分析仪在排除尿路感染中的应用评价[J]. 华西医学, 2013, 7:70-72. |
[14] | Evans R, Davidson MM, Sim LR, et al. Testing by Sysmex UF-100 flow cytometer and with bacterial culture in a diagnostic laboratory: a comparison[J]. J Clin Pathol, 2006, 59(6):661-662. |
[15] | 冯敏亚, 史伟峰. UC-3500与UF-5000流水线分析系统在诊断尿路感染中的价值[J]. 检验医学与临床, 2019, 16(12):1737-1740. |
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