本文關(guān)鍵詞：自動(dòng)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(dòng)化分析 復(fù)檢規(guī)則 顯微鏡檢 體液 細(xì)胞計(jì)數(shù)及分類

【摘要】：目的：針對(duì)不同的自動(dòng)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(duì)自動(dòng)化體液常規(guī)分析的復(fù)檢規(guī)則進(jìn)行初探。方法：1058例新鮮尿液標(biāo)本通過(guò)Siemens Atlas型全自動(dòng)干化學(xué)分析儀和4臺(tái)全自動(dòng)有形成份分析儀IRIS IQ200、AVE-766、US 2026、Sysmex UF-1000i檢測(cè)尿液常規(guī)指標(biāo),以相差顯微鏡人工鏡檢法作為參考方法,通過(guò)假陰性率和復(fù)檢率制定適合每個(gè)系列尿常規(guī)分析儀的最佳復(fù)檢規(guī)則。150份體液標(biāo)本,通過(guò)XE-5000全自動(dòng)血液分析儀體液模式進(jìn)行細(xì)胞計(jì)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(píng)估儀器法的可靠性,探討復(fù)檢規(guī)則。結(jié)果：?jiǎn)为?dú)使用干化學(xué)分析儀時(shí),(PR02+)+(RBC2+)+(WBC2+)+腎內(nèi)科來(lái)源的標(biāo)本進(jìn)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(shí),對(duì)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(yáng)不符或數(shù)量級(jí)不符或干化學(xué)PRO≥2+或沉渣CAST超出參考范圍；此時(shí)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(duì)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(yáng)不符或數(shù)量級(jí)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(yáng)不符時(shí),先非離心計(jì)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(jìn)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(xì)胞計(jì)數(shù)優(yōu)于BALF,漿膜腔積液的細(xì)胞分類計(jì)數(shù)優(yōu)于CSF和BALF。 HF-BF用于預(yù)測(cè)大細(xì)胞的ROC曲線下面積為0.806,優(yōu)于對(duì)瘤細(xì)胞的預(yù)測(cè)；此時(shí),cut-off值為3.60,診斷敏感度為0.82,特異度為0.76。細(xì)胞數(shù)低于490×106/L時(shí),精密度和準(zhǔn)確性均較差。結(jié)論：個(gè)性化的復(fù)檢規(guī)則,能控制自動(dòng)化尿常規(guī)的漏診率達(dá)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(xì)胞計(jì)數(shù)與分類優(yōu)于CSF和BALF,HF用于大細(xì)胞的預(yù)測(cè)優(yōu)于腫瘤細(xì)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(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R446.12

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本文編號(hào)：1421919