UF-1000i尿有形成分分析仪研究性参数在血尿来源鉴别中的应用

目的：探讨UF-1000i尿有形成分分析仪研究参数在鉴别肾性及非肾性血尿中的应用价值。方法回顾性分析血尿患者449例,其中肾性血尿患者259例,非肾性血尿患者190例。尿液标本用UF-1000i尿有形成分分析仪测定后记录各项参数测试结果,将红细胞研究性参数与患者临床诊断的符合情况进行统计分析。结果肾小球性血尿组与非肾小球性血尿组的RBC数值、RBC-P70Fsc、RBC-Fsc-DW、电导率及pH值等研究参数均存在明显差异,P〈0.01。两组数据的RBC-Info （红细胞形态信息）临床诊断符合率均较高,且非肾小球性血尿组的临床符合率随红细胞数量增多而升高,但肾小球性血尿组未有明显变化。结论 UF-1000i尿有形成分分析仪的研究参数对肾性及非肾性血尿的鉴别有较好的临床参考价值。     

Automated urinalysis: first experiences and a comparison between the Iris iQ200 urine microscopy system, the Sysmex UF-100 flow cytometer and manual microscopic particle counting.

BACKGROUND: Automated analysis of insoluble urine components can reduce the workload of conventional microscopic examination of urine sediment and is possibly helpful for standardization. We compared the diagnostic performance of two automated urine sediment analyzers and combined dipstick/automated urine analysis with that of the traditional dipstick/microscopy algorithm. METHODS: A total of 332 specimens were collected and analyzed for insoluble urine components by microscopy and automated analyzers, namely the Iris iQ200 (Iris Diagnostics) and the UF-100 flow cytometer (Sysmex). RESULTS: The coefficients of variation for day-to-day quality control of the iQ200 and UF-100 analyzers were 6.5% and 5.5%, respectively, for red blood cells. We reached accuracy ranging from 68% (bacteria) to 97% (yeast) for the iQ200 and from 42% (bacteria) to 93% (yeast) for the UF-100. The combination of dipstick and automated urine sediment analysis increased the sensitivity of screening to approximately 98%. CONCLUSIONS: We conclude that automated urine sediment analysis is sufficiently precise and improves the workflow in a routine laboratory. In addition, it allows sediment analysis of all urine samples and thereby helps to detect pathological samples that would have been missed in the conventional two-step procedure according to the European guidelines. Although it is not a substitute for microscopic sediment examination, it can, when combined with dipstick testing, reduce the number of specimens submitted to microscopy. Visual microscopy is still required for some samples, namely, dysmorphic erythrocytes, yeasts, Trichomonas, oval fat bodies, differentiation of casts and certain crystals.     

Urine sediment examination: a comparison of automated urinalysis systems and manual microscopy

BACKGROUND: Several automated instruments examining urine sediment have been introduced. We compared the performance of Sysmex UF-100 and Iris iQ200 with manual microscopy in urine sediment testing. METHODS: Four hundred and thirty-six urine samples were collected. The urine sediments were examined by manual microscopy and these 2 automated urinalysis systems. RESULTS: The within-run CVs for urine samples ranged from 3.4% to 22.3% for the iQ200, 1.6% to 24.2% for the UF-100 and 12.5% to 43.9% for manual microscopy. Between-run CVs on quality-control samples ranged from 6.1% to 32.4% for the iQ200 and 3.5% to 24.7% for the UF-100. The agreement between methods was good for red blood cells and white blood cells counts based on r values of 0.935 to 0.968. However, for epithelial cells, the values measured by different systems were poorly correlated (r=0.888-0.922). The Bland-Altman plot indicated a trend towards the automated cell count being greater than the manual microscopy as the epithelial cell count increased. Casts were difficulty differentiated by 2 automated systems. CONCLUSIONS: These 2 automated urinalysis systems demonstrated good concordance with each other in urine sediment examination. The automated process could be used as a screening procedure but some manual microscopy was still necessary.     

UF-100型尿沉渣检测仪测定红细胞影响因素的研究

目的　探讨草酸钙、非晶形盐、细菌、酵母菌在UF 10 0型尿沉渣全自动检测仪分析中对红细胞检测的干扰。方法　采用UF 10 0型尿沉渣全自动检测仪分析法、干化学分析法、镜检法共分析了 2 6 34份住院患者尿液标本 ,并将三者结果进行了比较。结果　单纯或混合性草酸钙、非晶形盐尿液标本 ,UF 10 0检测红细胞结果假阳性率为 95 % ;菌尿UF 10 0检测红细胞结果的假阳性率为 2 8% ;含酵母菌尿液UF 10 0检测红细胞结果假阳性率为 4 0 % ;正常对照组UF 10 0检测红细胞结果假阳性率为 5 %。与对照组相比 ,三者差异均有显著性 (P <0 .0 1)。结论　在UF 10 0型尿沉渣全自动检测仪分析中 ,草酸钙、非晶形盐、菌尿、酵母菌对红细胞检测的结果干扰很大 ,这对尿液检测质量控制具有重要的意义。将这 3种方法联合应用 ,可以提高检测结果的准确度 ,具有较高的临床应用价值。     

Quantitative urine particle analysis: integrative approach for the optimal combination of automation with UF-100 and microscopic review with KOVA cell chamber

BACKGROUND: Automated systems have enabled the counting of particles in urine to be standardized. Their superiority over traditional sediment analysis has been well documented, but they have not gained wide acceptance. The reasons for this are that sediment analysis has been performed and interpreted for decades. Additionally, pathologic casts and other unknown particles still must be confirmed under the microscope. Furthermore, comparison between the methods has revealed outliers and thus decreased confidence in automation. METHODS: We used the standardized KOVA cell chamber system to count particles and compared the results with UF-100 flow cytometry as an alternative to traditional sediment analysis. RESULTS: We compared 252 randomly selected urine samples and obtained a review rate of 33%. Microscopic verification was necessary because of the presence of casts, yeast, sperm, dysmorphic erythrocytes, and some misclassified erythrocytes or leukocytes that were detected by incongruent dipstick results and abnormal scattergrams. We obtained correlation coefficients of 0.966 for erythrocytes and 0.935 for leukocytes. Criteria for an algorithm to identify samples that needed microscopic review were derived from comparisons between the number of particles from UF-100, dipstick results, cell chamber counting, and sediment analysis. CONCLUSIONS: Automated cell counting combined with microscopic counting with a standardized cell chamber system is useful. An objective algorithm for review criteria can be developed via systematic comparison of UF-100 flow cytometry and microscopy. Only urine samples that meet these criteria need to be confirmed microscopically.     

尿液流水线分析系统联合显微镜检对尿路感染的诊断价值

目的 探讨Sysmex UC-3500尿干化学分析仪(简称UC-3500)与UF-5000尿沉渣分析仪(简称UF-5000)的相关参数联合尿沉渣显微镜检在诊断尿路感染(UTI)中的应用价值.方法 对该院2021年2—3月1036例患者的清洁中段尿进行尿干化学分析、流式尿沉渣分析及尿离心显微镜检,另送尿培养鉴定,以尿培养...     

流式细胞技术对尿中红细胞检测的临床价值

目的评价流式细胞技术对尿红细胞检测的效能。方法随机留取尿液标本1318例,分别用UF-50尿沉渣分析仪和显微镜检测尿中红细胞。结果尿沉渣红细胞计数以显微镜检查为标准,UF-50尿沉渣分析仪测定尿红细胞阳性率（13．05％）高于镜检（9．18％）,二者阳性符合率为70％。结论结晶、酵母菌、滴虫、脂肪滴、精子及大量细菌导致UF-50尿沉渣分析仪检测红细胞易受干扰,不能完全代替镜检,但可作为一种过筛和治疗监控的手段,有很高的临床应用价值。     

尿干化学与流式细胞术联合用于尿液有形成分镜检筛选的研究与应用

目的 制定针对UF-1000i尿液分析流水线(由UF-1000i尿流式分析仪和AX-4030尿干化学分析仪组成)自动化检测结果的尿液镜检复检规则.方法 收集2009年9月至2010年2月解放军总医院尿液常规标本共2 839份.首先利用UF-1000i尿液分析流水线对2 839份尿液标本进行有形成分分析(包括RBC、WB...     

UF-100尿沉渣分析仪尿液有形成分检测假阳性结果原因分析及其对策

目的探讨影响UF-100尿沉渣分析仪尿液有形成分检测的影响因素，寻找导致其测定假阳性结果的原因及其对策。方法分别采用UF-100尿沉渣分析仪和显微镜检查法对1000例临床尿液标本进行检测，对比两种方法的检测结果，分析引起UF-100尿沉渣分析仪测定假阳性的原因。结果UF-100尿沉渣分析仪检测管型假阳性率为7．3％，粘液丝是引起其假阳性的最主要原因；红细胞假阳性率为11．9％，一定量的结晶、细菌和酵母样菌易被仪器错误报告为红细胞；白细胞的假阳性率为5．9％，小圆上皮细胞、滴虫和大量细菌是引起白细胞假阳性的主要原因；小圆上皮细胞的假阳性率为2．0％，白细胞是导致其计数假阳性的常见原因。结论因多种因素可以影响UF-100尿沉渣分析仪对尿液有形成分的检测结果，出现假阳性，因此，应用UF-100尿沉渣分析仪检测尿液有形成分只能作为一种初步筛查方法，当尿液病理成分检测结果提示增多，同时上述干扰成分亦呈阳性或增多时，沉渣镜检十分重要。     

电导率对肾脏浓缩稀释功能检测的意义

目的评价UF-100尿沉渣分析仪检测电导率用于肾脏浓缩稀释功能检测的价值。方法140例标本配对用UF-100尿沉渣分析仪测定电导率和冰点渗透压计测定渗透压。两法也同时用于尿崩症患者的禁水-加压素试验。结果电导率和渗透压测定结果高度相关,r=0.8583,P<0.01,渗透压对电导率的直线回归方程为Y=33.913X-98.024。重复性实验电导率CV为2.6%,渗透压CV为3.4%。结论电导率可作为正确评价肾脏浓缩稀释功能的一个良好的替代参数。     

Automation of urine sediment examination: a comparison of the Sysmex UF-100 automated flow cytometer with routine manual diagnosis (microscopy, test strips, and bacterial culture).

Urine specimens from 438 patients were examined with the UF-100 flow cytometer (Sysmex TOA Medical Electronics (Europe) GmbH, Hamburg, Germany) and by manual microscopy and test strips. One hundred and forty-two of these were also examined bacteriologically. The measurements with the UF-100 were performed on native urine without prior centrifugation. Intraassay imprecision, CV of 1.3% (547/microliter) to 8.5% (24/microliter) for erythrocytes and CV of 2.4% (218/microliter) to 5.6% (10/microliter) for leukocytes, are similar to those usual in clinical chemistry, and are very much better than those seen in manual microscopy of sediment. In routine use, overloading the flow cytometer by an excessive concentration of particles was observed in 9% of specimens. Such specimens should be checked visually. The UF-100 is distinctly more sensitive than manual microscopy for determining leukocytes, erythrocytes, epithelial cells and bacteria. Reference ranges were estimated from the results obtained. These enabled the UF-100 to replace routine manual diagnostic methods. Although the sensitivity is improved over manual microscopy of sediment, it is always necessary to perform parallel test strip examination when determining erythrocytes in order to detect haemolysis. In our opinion the Sysmex UF-100 is a suitable replacement for manual microscopy of urine sediment. In addition it offers an opportunity to improve standardization of basic urinalysis.     

Stepwise strategies in analysing haematuria and leukocyturia in screening.

The aim of the present work was to compare in a supposed healthy population of 680 subjects several algorithms for positive selection of urine samples requiring microscopic examination for erythrocytes and leukocytes after screening by automated test-strip measurement and particle counting on a Sysmex UF-50 flow cytometer. Four strategies have been formulated and the sensitivity, specificity, positive predictive value, negative predictive value, false positive rate, false negative rate, and microscopic review rate were measured. The strategy combining test strip analysis and automated counting on all samples, followed by microscopic examination of only discordant samples gave the best results. When the two methods of haematuria screening were in agreement (91% of samples), the false negative rate for microscopy was 1.1%, with a false positive rate of 0.8%, sensitivity of 66% and specificity of 99%, and the results are acceptable without any other examination. When the two methods of haematuria screening were discrepant, visual microscopic analysis was necessary to obtain definitive results. For leukocyturia screening, 80% of results were in agreement by test strip and automatic sediment urinalysis, with only ten results considered as false negatives (1.8%) and four as false positives (0.7%). Agreement was good and the other criteria were good (sensitivity 79%, specificity 99%). On conflicting samples, there was no agreement between methods and microscopic analysis was essential. The benefit of such an algorithm would be optimisation of the workflow without any loss of sensitivity and specificity at the expense of a two-fold increase in cost.     

Clinical laboratory automated urinalysis: comparison among automated microscopy, flow cytometry, two test strips analyzers, and manual microscopic examination of the urine sediments

Urinalysis is one of the habitual clinical laboratory procedures, which implies that one of the largest sample volumes currently requires significant labor to examine microscopic sediments. Different analyzers currently used to perform this task have been compared with the manual microscopic sediment examination. The Atlas Clinitek 10 (Bayer Corporation, Diagnostics Division, Tarrytown, NY) and Urisys 2400 (Hitachi Science Systems Ltd., Ibaraki, Japan) test strips analyzers and two automated urinalysis systems, Sysmex UF-100 (Sysmex Corporation Kobe, Japan) and IRIS iQ200 (International Imaging Remote Systems, Chatsworth, CA), have been considered. We assessed the concordance between the results obtained from 652 freshly collected urine samples for erythrocytes (RBC), leukocytes (WBC), squamous epithelial cells (EC), nitrites/bacteria, and crystals using the methodologies mentioned. A principal components analysis was performed in order to examine the correlation between these parameters. Instrument accuracy was also assessed. The Spearman's statistic (p) showed an adequate agreement between methods for RBC (iQ200=0.473; UF-100=0.439; Atlas=0.525; Urisys=0.539), WBC (iQ200=0.695; UF-100=0.761; Atlas=0.684: Urisys=0.620), and bacteria/nitrites (iQ200=0.538; UF-100=0.647; Atlas=0.532; Urisys=0.561) counts. By applying the Wilcoxon and McNemar tests, a concordance degree was found between 82-99 and 52-95% for the values obtained from the two test strips analyzers considered and from the iQ200 and UF-100 systems, respectively. From these results, we can conclude that both test strips analyzers are similar and, on the other hand, that automated urinalysis is needed to improve precision and the response time; but sometimes manual microscopic revisions are required, mainly when flags, because of crystals, are detected.     

The efficient workflow to decrease the manual microscopic examination of urine sediment using on-screen review of images

BackgroundThe manual microscopic examination (MME) of urine sediment is labor-intensive, time-consuming, and imprecise. Therefore, automated urinalysis systems based on flow cytometry or digital imaging techniques could replace MME. The purpose of this study was to evaluate the rate of MME using two automated urine sediment analyzers, alone and in combination.MethodsThis study was conducted using the freshly collected urine specimens of 1055 in-patients and 1119 out-patients. All samples were analyzed using UF-1000i (Sysmex Corporation) and Cobas 6500 instrument (Roche Diagnostics International). The rate of MME was evaluated using two analyzers, both individually and in combination.ResultsUsing the UF-1000i alone, 34.2% and 16.8%, respectively, of in- and out-patient samples were analyzed by MME, compared to 15.6% and 3.7%, respectively, using the Cobas 6500. In combined assay using the UF-1000i followed by the Cobas 6500, 27.9% and 11.3% in-patient samples required on-screen review and MME, respectively. And the respective rates were 10.3% and 2.7% of out-patient. Samples using the Cobas 6500 followed by the UF-1000i, 42.3% and 11.3% in-patient needed on-screen review and MME, respectively. And the respective rates were 18.9% and 2.7% of out-patient samples.ConclusionsUse of the Cobas 6500 compared to the UF-1000i resulted in decreases in the rate of MME from 34.2% to 15.6% for in-patient samples, and from 16.8% to 3.7% for out-patient samples. Use of the Cobas 6500 reduced the rate of MME, and compared to use of only the Cobas 6500, the combined use resulted in a reduction in the rate of on-screen review.     

尿沉渣分析仪在肾性与非肾性血尿鉴别中的应用价值

目的 探讨尿沉渣分析仪sysmexUF-100在鉴别血尿来源中的应用价值。方法 用UF-100检测80例不同来源血尿样本的红细胞。结果 应用UF-100检测变异性尿红细胞对肾小球性血尿诊断的敏感性为90％，特异性为75％。结论 用UF-100检测变异性尿红细胞以诊断肾小球性血尿的敏感性高，特异性强，可作为鉴别肾小球性与非肾小球性血尿的筛选方法。     

三种方法在尿液有形成分分析中的对比观察

目的 探讨UF-1000i尿液有形成分分析仪与干化学方法、手工显微镜检查尿中红细胞(RBC)、白细胞(WBC)的符合情况及影响因素.方法 使用UF-1000i 尿有形成分分析仪、干化学分析仪与显微镜分别检测996例尿液标本中RBC、WBC,将3种方法的检测结果进行比较.结果 分别以RBC、WBC超过25和30个/μL为...     

UF-1000i尿液有形成分分析仪、干化学法和镜检法对尿液分析的比较

目的探讨Sysmex UF-1000i全自动尿液有形成分分析仪（简称UF-1000i）对尿液中红细胞（RBC）、白细胞（WBC）和管型（CAST）检测的敏感性。方法对1 054例患者的尿液分别用UF-1000i、URISys-2400全自动干化学分析仪（干化学法）及Diasys R/S2005定量分析工作站（镜检法）3种方法进行分析,并比较3种方法对RBC、WBC、CAST的检测敏感性。结果 UF-1000i检测RBC、WBC、CAST的阳性率分别为20.6%、20.3%、6.7%;干化学法检测出RBC、WBC的阳性率分别为24.5%、17.9%;镜检法检出RBC、WBC、CAST的阳性率分别为16.9%、20.5%、2.2%。3种方法RBC、CAST的检出率差异有统计学意义（P〈0.01）,WBC的检出率差异无统计学意义（P〉0.05）。结论 UF-1000i不能完全取代尿沉渣镜检,建议3种方法联合应用以减少检验误差,提高尿液分析质量。     

UF-500i与IQ200尿沉渣分析仪检测管型的比较和评价

目的比较UF-500i与IQ200尿沉渣分析仪在检测管型中的敏感度、特异度和影响因素。方法采用UF-500i、IQ200尿沉渣分析仪和离心沉淀显微镜法分别检测门诊肾病患者晨尿标本,以人工镜检法作为标准对两种仪器敏感度、特异度进行分析。结果480份晨尿标本中,UF-500i尿沉渣分析仪敏感度为97．1％（68／70）,特异度为76．6％（314／410）;IQ200尿沉渣分析仪人工修饰前后敏感度分别为91．4％、100％（64／70,70／70）,特异度为70．5％／98．3％（289／410,403／410）。结论UF-500i与IQ200尿沉渣分析仪具有较高的管型检测灵敏度,但假阳性率高,均需人工复核以提高准确性。     

尿液细胞成分定量分析方法学研究

目的探讨并比较尿液有形成分定量方法与镜检定量计数的关系。方法 采用离心和不离心，人工和自动化仪器（镜检计数定量和仪器定量计数），同一标准和实验方案和多中心的方法，分析尿液有形成分定量方法之间的差异。结果离心定量检测法有形成分误差较大。不离心多样品量的细胞计数（扩大细胞计数范围）、UF-100尿流式分析仪及AVE-763全自动尿沉渣智能镜检分析仪能较为真实反映尿有形成分的实际浓度。结论规范尿液离心检查法对于检查尿液病理性有形成分是泌尿系统疾病诊断的理想方法，但不适用于沉渣有形成分定量。未离心多细胞数量的镜检定量能较准确反映沉渣有形成分的实际浓度。UF-100和AVE-763分析仪由于计数细胞数量多，能较为准确反映尿液的真实情况。但对于细胞识别的功能则应另行探讨。     

UF-1000i尿液沉渣分仪析检测尿红细胞的影响因素

目的：探讨UF-1000i尿液沉渣分仪析检测尿红细胞（Red Blood Cell, RBC）影响因素。方法对住院病人400例晨尿标本同时进行UF-1000i尿液沉渣分仪析检测和尿沉渣显微镜检查,分析两者结果的差异。结果400例受检标本中,UF-1000i检测RBC阳性144例,阳性率36.0%,显微镜检测的RBC阳性131例,阳性率32.8%,尿沉渣分析仪RBC检测结果与镜检结果比较存在假阳性。两种方法检测RBC的差异有统计学意义（χ2=6.85714,P＆lt;0.01）。结论当尿液中细菌集簇分布、酵母菌污染、存在草酸钙结晶等可引起UF-1000i尿液沉渣分析仪尿RBC检测结果假阳性,应通过显微镜镜检来纠正其对尿RBC检测的影响。