[1]王婉妮,陈雅斌,苗 杰.尿液肾小管上皮细胞和病理管型检测对高胆红素血症肾损伤的诊断价值[J].现代检验医学杂志,2025,40(01):185-188.[doi:10.3969/j.issn.1671-7414.2025.01.035]
　WANG Wanni,CHEN Yabin,MIAO Jie.Diagnostic Value of Urine Renal Tubular Epithelial Cell and Pathological Cast Detection for Renal Injury in Hyperbilirubinemia[J].Journal of Modern Laboratory Medicine,2025,40(01):185-188.[doi:10.3969/j.issn.1671-7414.2025.01.035]
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尿液肾小管上皮细胞和病理管型检测对高胆红素血症肾损伤的诊断价值()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年01期
页码:
185-188
栏目:
论著
出版日期:
2025-01-15

文章信息/Info

Title:
Diagnostic Value of Urine Renal Tubular Epithelial Cell and Pathological Cast Detection for Renal Injury in Hyperbilirubinemia
文章编号:
1671-7414（2025）01-185-04
作者:
王婉妮1，陈雅斌1，苗 杰2
（1. 福建医科大学附属泉州第一医院检验科，福建泉州 362000；2. 联勤保障部队第970 医院威海医疗区检验科，山东威海 264200）
Author(s):
WANG Wanni1, CHEN Yabin1, MIAO Jie2
(1. Department of Clinical Laboratory，Quanzhou First Hospital Affiliated to Fujian Medical University，Fujian Quanzhou 362000，China；2. Department of Clinical Laboratory，Weihai Medical Area，970 Hospital of Joint Logistics Support Force，Shandong Weihai 26420
关键词:
肾小管上皮细胞;  病理管型;  高胆红素血症; 肾损伤
分类号:
R692.9；R446.12
DOI:
10.3969/j.issn.1671-7414.2025.01.035
文献标志码:
A
摘要:
目的 研究Sysmex UF5000 尿液分析仪检测尿液中的肾小管上皮细胞(RTEC) 和病理管型(Path.CAST) 筛查高胆红素血症肾损伤的诊断价值。方法 回顾性分析2023 年2 月～ 2024 年1 月就诊于泉州市第一医院的高胆红素血症患者尿液有形成分的分析结果。根据是否发生肾损伤分为非肾损伤组（n=174）和肾损伤组（n=84），比较两组尿液中RTEC 水平和Path.CAST 阳性率的差异，受试者工作特征(ROC) 曲线分析评估RTEC 筛查高胆红素血症肾损伤的诊断性能。并进一步分析RTEC，Path.CAST 单项目或联合用于筛查的敏感度、特异度、阳性预测值、阴性预测值。结果肾损伤组RTEC 水平［5.2(3.2 ～ 12.3) /μl］，Path.CAST 阳性率（36.90%）明显高于非肾损伤组[1.3(0.7 ～ 2.2)/μl，3.45%]，差异具有统计学意义（Z/χ?=-10.215，51.620，均P<0.001）。RTEC 可有效筛查高胆红素血症中肾损伤的患者，其AUC（95%CI）为0.892(0.846 ～ 0.939)，筛查的最佳cut-off 值为3.15/μl，约登指数0.688。当RTEC>3.15/μl 或Path.CAST阳性时，其筛查高胆红素血症肾损伤时的敏感度和阴性预测值最高，分别为83.33% 和91.57%。而以Path.CAST 阳性为筛查条件时，其特异度和阳性预测值最高，分别为96.55% 和83.78%。结论 尿RTEC 可有效地筛查高胆红素血症肾损伤，当RTEC ≤ 3.15/μl 或Path.CAST 阴性时，可以基本排除高胆红素血症发生肾损伤的可能。
Abstract:
Objective To study the diagnostic value of Sysmex UF5000 urine analyzer detection of renal tubular epithelial cells (RTEC) and pathological cast (Path. CAST) in urine to screen for hyperbilirubinemia-induced renal injury. Methods A retrospective analysis was conducted on the urine sediment analysis results of patients with hyperbilirubinemia who visited the Quanzhou First Hospital from February 2023 to January 2024. According to the occurrence of renal injury, they were divided into a non-renal injury group（n=174）and a renal injury group（n=84）. Compared the RTEC levels and the positive rate of Path. CAST in urine between two groups. Receiver operating characteristic(ROC) curve analysis was used to evaluate the diagnostic performance of RTEC screening for hyperbilirubinemia-induced renal injury, and further analyzed the sensitivity, specificity, positive predictive value(PPV), and negative predictive value(NPV) of RTEC and Path.CAST single or combined screening. Results The RTEC［5.2(3.2 ～ 12.3) /μl］level in the renal injury group, and the positive rate of Path.CAST positivity rate （36.90%）, which was significantly higher than that of the non-renal injury group [1.3 (0.7 ～ 2.2)/μl，3.45%], the differences were statistically significant (Z/χ? =-10.215，51.620，all P<0.001). RTEC could effectively screen patients with renal injury in hyperbilirubinemia, with an AUC (95%CI) of 0.892 (0.846~0.939) and an optimal cut-off value of 3.15/μl for screening. The Youden index was 0.688. When RTEC>3.15/μl or Path.CAST positive was used, its sensitivity and NPV for screening for hyperbilirubinemia-induced renal injury were the highest, with 83.33% and 91.57%, respectively. When Path.CAST positive was used as the screening condition, its specificity and PPV were the highest, with 96.55% and 83.78%, respectively. Conclusion Urinary RTEC can effectively screen for renal injury caused by hyperbilirubinemia when RTEC ≤ 3.15 /μl or Path.CAST is negative, the possibility of renal injury caused by hyperbilirubinemia can be ruled out.

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备注/Memo

备注/Memo:
作者简介：王婉妮（1996-），女，本科，技师，研究方向：临检体液检测及临床应用，E-mail：616745012@qq.com。
通讯作者：苗杰（1986-），女，硕士研究生，副主任技师，研究方向：临检和分子生物学诊断，E-mail：miaojie404@163.com。
更新日期/Last Update: 2025-01-15