Clinical Application Research Of Urine Dreg Integration Platform And Evaluation To Identify The Source Of Hematuria

Object:To establish the urine sediment holistic analysis platform and the evaluation system to discriminate between glomerular hematuria and non-glomerular hematuria. To evaluate the clinical value of application of the urine sediment holistic analysis platform and the evaluation system in the discriminate between glomerular hematuria and non-glomerular hematuria.Method:1. The establishment of the urine sediment holistic analysis platform: First, we need to install the Combi scanXL automatic urine analyzer and UF-1000i automated urinalysis analyzer. Then, we need to bind the Combi scanXL automatic urine analyzer to UF-1000i automated urinalysis analyzer in Laboman UriAccess by clicking "binding instrument" in toolbar. Click the "system registration" in the "Set up", enter the registration number, register the Combi scanXL automatic urine analyzer and UF-1000i automated urinalysis analyzer. Click the "system settings" in the "set up" of laboman, open the"communication program" to start SDF communication transmission, complete the set up of the urine sediment holistic analysis platform. We detect the urine specimens by using the Combi scanXL automatic urine analyzer.2. The establishment of the evaluation system to discriminate between glomerular hematuria and non-glomerular hematuria:Detect the Urine occult blood, total number of red blood cells, RBC-info, RBC-P70-Fsc, RBC-Fsc-DW and the scatter chart of RBC, the Histogram chart of RBC, the percentage of RBC forms in the phase contrast microscope through the urine sediment holistic analysis platform, we analysis and sum up these dates through the ELIMS.3. We accute the reference ranges of Urine occult blood, the total number of red blood cells, RBC-info, RBC-P70-Fsc, RBC-Fsc-DW and the scatter chart of RBC, the histogram chart of RBC in norm people.4. We accute the reference ranges of RBC-P70-Fsc, RBC-Fsc-DW and the scatter chart of RBC, the histogram chart of RBC when the positive occult blood in urine, total number of red blood cells in urine in the microscope≥8000/ML, the results of RBC-info and phase contrast microscope are non-uniform RBCS.5. We accute the reference ranges of RBC-P70-Fsc, RBC-Fsc-DW and the scatter chart of RBC, the histogram chart of RBC when the positive occult blood in urine, total number of red blood cells in urine in the microscope>8000/ML, the results of RBC-info and phase contrast microscope are uniform RBCS.6. We accute the reference ranges of RBC-P70-Fsc, RBC-Fsc-DW and the scatter chart of RBC, the histogram chart of RBC when the positive occult blood in urine, total number of red blood cells in urine in the microscope>8000/mL, the results of RBC-info and phase contrast microscope are mixed RBCS.7. When the positive occult blood in urine, the total number of red blood cells in urine is increase, we compare the consistency of the RBC-P70Fsc, scatter chart of RBC, the histogram chart of RBC with the RBC type in phase contrast microscope.8. we compare the results of the RBC type in the phase contrast microscope, UF-1000i automated urinalysis analyzer, the urine sediment holistic analysis platform. 9. we also compare the sensitivity, the specificity and the clinical coincidence rates in the phase contrast microscope, UF-1000i automated urinalysis analyzerand the urine sediment holistic analysis platform.Outcome:1. The reference ranges of the total number of red blood cell in UF-1000i is15.81/μL in normal people when the negative occult blood in urine and RBS-info shows no classification.2. Non-uniform hematuria patients:When positive occult blood in urine, total number of red blood cells in urine in the phase contrast microscope≥8000/mL and the results of RBC-info and Phase contrast microscope are Non-uniform RBCS, RBC-P70Fsc<70.5ch, Most red blood cells locate in the ordinate which the value<70.0ch in the scatter chart. The Histogram chart is scatter and multimodal, the Peak locate in the abscissa<69.5ch, RBC-Fsc-DW≥25.5ch.3. Uniform hematuria patients:when positive occult blood in urine, total number of red blood cells in urine in the microscope≥8000/ml,the results of RBC-info and phase contrast microscope are uniform RBCS, RBC-P70Fsc>98.0ch, Most red blood cells locate in the ordinate which the value>98.0ch in the scatter chart.The histogram chart is sharp and singlet,the peak locate in the abscissa>99.0ch, RBC-Fsc-DW<27.0ch.4. Mixed hematuria patients:When positive occult blood in urine, total number of red blood cells in urine in the microscope>8000/ml, the results of RBC-info and phase contrast microscope are mixed RBCS, the value of RBC-P70-Fsc is70.5～98.0ch, Most red blood cells locate in ordinate which the value is70.0～98.0ch in the scatter chart,the histogram chart is multimodal, the peak locate in the abscissa69.5～99.0ch, RBC-Fsc-DW>37.0ch. 5. Positive occult blood in urine, the total number of red blood cells is increase.The consistencies of RBC types in the Phase contrast microscope with RBC-P70-Fsc, scatter chart, histogram chart are90.3%,85.9%,91.0%; The value of Kappa are0.830,0.747,0.845.6. We conduct the comparative analysis of UF-1000i urine sediment analyzer, holistic analysis system, phase contrast microscope. We use the RBC in phase-contrast microscopy as a reference, the consistencies of UF-1000i, holistic analysis system are84.5%.94.8%, the value of Kappa are0.730,0.909.7. The sensitivities of identification the non-glomerular hematuria and glomerular hematuria are90.0%.84.0%.96.0%among the UF-1000i urine sediment analyzer, phase contrast microscope, holistic analysis system. The specificities of identification the non-glomerular hematuria and glomerular hematuria are82.35%.88.24%.94.12%; The overall compliance rates are89.55%,85.07%,95.52%.Conclusion:1. Using the urine overall analysis application platform and comprehensive evaluation system to identify glomerular and non-glomerular hematuria hematuria, it’s specificity and sensitivity and clinical compliance rate are higher than phase contrast microscope method and the UF-1000i separate analysis;2. Prove the urine overall analysis application platform is the most objective, accurate and reliable and effective methods in identifing parts of hematuria. The urine overall analysis application platform has important clinical significance and application value in identifing parts of hematuria.3. urine dreg integrative comprehensive analysis can effectively exclude crystallization, yeast, fat bodies, and cause RBC and occult blood test false positives/negatives interference, and avoid subjective factors on the results of phase contrast microscope method, it is of great significance for quality control of urine analysis.