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尿分析参数在预测尿路感染中的表现:一个尺寸适合所有吗?
Sonali D Advani1, Rebecca North2, Nicholas A Turner1
1Division of Infectious Diseases, Department of Medicine, Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine.
概括
尿路感染 (UTI) 的尿液分析测试在诊断该病症方面表现不佳. 虽然结合像皮尤里亚或酸盐这样的测试提高了排除尿路感染的准确性,但老年女性的表现仍然很低.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
- 临床诊断 临床诊断 临床诊断
背景情况:
- 尿路感染很常见,需要准确的诊断方法.
- 尿液分析是疑似尿路感染的常用初始诊断工具.
- 尿液分析参数的诊断性能需要持续评估.
研究的目的:
- 评估尿路感染的单个和联合尿液分析参数的诊断准确性.
- 在一个大型的多医院患者队列中评估尿液分析的预测价值.
- 在特定的人口群体,包括老年女性中调查尿液分析的性能.
主要方法:
- 一项涉及3392名患者的多医院队列研究.
- 对阳性尿分析参数的分析,包括皮尤里亚和化物.
- 对排除UTI的积极预测值和性能进行评估.
主要成果:
- 单个尿液分析参数显示,对诊断尿路感染的积极预测值较低.
- 结合的参数 (皮尤里亚或酸盐) 显示,与单独的皮尤里亚相比,排除尿路感染的性能有所改善.
- 所有测试的尿液分析参数都显示老年妇女的诊断性能不佳.
结论:
- 标准尿液分析参数在一般患者群体中诊断尿路感染的准确性有限.
- 结合特定的尿分析标记物可能会提高它们在排除尿路感染方面的效用.
- 尿液分析在老年女性患者的尿路感染诊断中特别不可靠,这表明需要使用替代诊断策略.
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