本文關(guān)鍵詞：自動化尿液及體液常規(guī)分析的復(fù)檢規(guī)則制定及探討　出處：《北京協(xié)和醫(yī)學(xué)院》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 尿常規(guī) 自動化分析 復(fù)檢規(guī)則 顯微鏡檢 體液 細胞計數(shù)及分類

【摘要】：目的：針對不同的自動化尿常規(guī)分析系統(tǒng),制定各自的形態(tài)學(xué)復(fù)檢規(guī)則；對自動化體液常規(guī)分析的復(fù)檢規(guī)則進行初探。方法：1058例新鮮尿液標本通過Siemens Atlas型全自動干化學(xué)分析儀和4臺全自動有形成份分析儀IRIS IQ200、AVE-766、US 2026、Sysmex UF-1000i檢測尿液常規(guī)指標,以相差顯微鏡人工鏡檢法作為參考方法,通過假陰性率和復(fù)檢率制定適合每個系列尿常規(guī)分析儀的最佳復(fù)檢規(guī)則。150份體液標本,通過XE-5000全自動血液分析儀體液模式進行細胞計數(shù)和分類,結(jié)合人工鏡檢法、瑞氏-吉姆薩及蘇木素-伊紅染色法評估儀器法的可靠性,探討復(fù)檢規(guī)則。結(jié)果：單獨使用干化學(xué)分析儀時,(PR02+)+(RBC2+)+(WBC2+)+腎內(nèi)科來源的標本進行復(fù)檢的方案最佳,假陰性率小于臨床可接受水平(5%),為4.65%,鏡檢率為40.41%。聯(lián)合干化學(xué)與有形成份時,對于干化學(xué)聯(lián)合IRIS IQ200、AVE-766、US 2026的最佳復(fù)檢方案為；干化學(xué)BLD≥2+(女性2+)或RBC超出參考范圍2倍或WBC陰陽不符或數(shù)量級不符或干化學(xué)PRO≥2+或沉渣CAST超出參考范圍；此時假陰性率分別為1.94%、2.03%、1.74%,鏡檢率分別為41.09%、40.12%、44.86%。對于干化學(xué)聯(lián)合Sysmex UF-1000i的最佳復(fù)檢方案為：干化學(xué)BLD≥2+(女性2+)或RBC超出參考范圍2倍或WBC陰陽不符或數(shù)量級不符或干化學(xué)PRO≥2+或沉渣CAST超出參考范圍,當(dāng)干化學(xué)BLD與有形RBC陰陽不符時,先非離心計數(shù)RBC/μ1,根據(jù)鏡檢結(jié)果適當(dāng)修正干化學(xué)或有形RBC后再進入規(guī)則；其假陰性率為1.65%、總鏡檢率為50.39%。漿膜腔積液和CSF的細胞計數(shù)優(yōu)于BALF,漿膜腔積液的細胞分類計數(shù)優(yōu)于CSF和BALF。 HF-BF用于預(yù)測大細胞的ROC曲線下面積為0.806,優(yōu)于對瘤細胞的預(yù)測；此時,cut-off值為3.60,診斷敏感度為0.82,特異度為0.76。細胞數(shù)低于490×106/L時,精密度和準確性均較差。結(jié)論：個性化的復(fù)檢規(guī)則,能控制自動化尿常規(guī)的漏診率達到臨床可接受水平,并具有臨床可操作性；XE-5000體液模式用于漿膜腔積液的細胞計數(shù)與分類優(yōu)于CSF和BALF,HF用于大細胞的預(yù)測優(yōu)于腫瘤細胞。
[Abstract]:Objective: to automate routine urine analysis for different systems, making their morphological criteria; for routine analysis of the criteria of automated fluid were studied. Methods: 1058 cases of fresh urine samples by Siemens Atlas automatic chemical analyzer and 4 automatic analyzer IRIS IQ200 components AVE-766, US, 2026, Sysmex UF-1000i urine routine index, reference method using phase contrast microscope as artificial microscopy, the false negative rate and rate of re examination rules and make the best.150 parts of body fluid specimens for each series of urine analyzer, cell counting and classification by XE-5000 automatic blood analyzer fluid model, combined with artificial microscopy, Wright Giemsa and hematoxylin eosin staining method to investigate the reliability evaluation instrument, review criteria. Results: single use dry chemical analyzer, (PR02+) + (RBC 2+) + (WBC2+) + nephrology sources were re examination of the best solution, the false negative rate is less than the clinically acceptable level (5%), 4.65%, 40.41%. combined with dry chemical and physical composition rate during bronchoscopy, for dry chemical combined with IRIS IQ200, AVE-766, US 2026 is the best solution for re examination; dry BLD = 2+ (chemical female 2+) or RBC beyond the reference range of 2 times or WBC and inconsistent or magnitude or not more than 2+ or PRO dry chemical sediment CAST beyond the reference range; the false negative rate were 1.94%, 2.03%, 1.74%, examination rate is respectively 41.09%, 40.12%, 44.86%. for the best review program dry chemical combined with Sysmex UF-1000i for BLD = 2+: dry chemical (female 2+) or RBC beyond the reference range of 2 times or WBC and inconsistent or magnitude or not more than 2+ or PRO dry chemical sediment CAST beyond the reference range, when the dry chemistry BLD and physical RBC of yin and Yang is inconsistent, the first non centrifugal counting RBC/ 1, According to the microscopic examination of the modified dry chemical or physical RBC before entering the rule; the false negative rate was 1.65%, the total rate of microscopic cell counting is better than BALF 50.39%. and CSF in serous cavity effusion, serous effusion cell count and BALF. is better than CSF HF-BF for predicting ROC curve area of large cells was 0.806 better than the prediction of tumor cells; at the same time, the cut-off value was 3.60, the diagnostic sensitivity was 0.82, specificity of 0.76. cell count below 490 * 106/L, precision and accuracy were poor. Conclusion: the personalized examination rules, can control the automatic urinary routine clinical misdiagnosis rate reached an acceptable level, and has the clinical operation mode for XE-5000 fluid; serous effusion cell count and classification is better than that of CSF and BALF, HF for the prediction of tumor cells is better than that of large cells.

【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R446.12

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本文編號：1421919