葡萄糖对尿液白细胞干化学法测定影（The effect of glucose on urine white cell dry chemical method）

葡萄糖对尿液白细胞干化学法测定影（The effect of glucose on urine white cell dry chemical method） 葡萄糖对尿液白细胞干化学法测定影(The effect of glucose on urine white cell dry chemical method) W... 27 fall you fame! Only Sheng Sheng plastic wire dried ieArl9Vl4N. 4! CN, pi20 00, o2.04 Article number: 1673 - 8640 (20) 009) 04-0274-04 CLC number: R4 446.12 document identification code: A The effect of glucose on the determination of urine white cells by dry chemical method Xi Xueqin, Mu yuan, Jin Yue.. (1. 、 Department of clinical laboratory, Huai'an Hospital Affiliated to Xuzhou Medical College, Jiangsu, Huaian 2230 002:.. 2. 、 the first clinical medical school of Nanjing Medical University, Jiangsu, Nanjing, 210029.) Abstract: objective Gl) the effect of WB measurement, Analysis of glucose (U) in urine white blood cell (C) dry chemical esterase (dry chemical method) was used to improve the detection Accuracy of measurement. Methods the clinical data of 584 patients with positive WBC microscopy were analyzed retrospectively, and the results of Glu and WBC dry chemistry were reviewed WBC dry chemical results respectively, + +, + +, + + Fresh urine positive + + 5 copies each, each 2 tube (l0mL per tube), divided into Glu group and join H. 0: join the group, each group of samples added different concentrations of Glu and H:O: and dry chemical determination. In the Glu adding group, each time the determination was used Remove the test strip of the Gl module and make repeated measurements. As a result.. 8Gl+u++ ++C dry chemistry false Yin Results u54 cases in urine, u++ group and Gl group. + WB The sex ratio was higher than that in Glu negative group (P=0.0 001, P=0.0 000). The positive number of WBC dry chemistry decreased with the increase of urine Glu concentration (0R) =0.100, P=0.0 000], but not affected by H2O2. Conclusion the urinary Glu concentration is 83.3 Urine WBC was dried at 33mmol / L (15g / L) The interference of measurement has been obviously disturbed, and the degree of interference increases with the increase of urine Glu concentration. It is Glu that interferes with urine WBC dry chemical determination instead of Glu mode The reaction product H:0 of the block. Keywords: glucose; leukocyte esterase; urinalysis; dry chemistry Investigationoftheef FfectsofglucoseonurineleukocyteesterasetestX / XueqinMUYuan. 1lNYue1... (1DprmnolnclaoaoyHa'nHsia, uhuMeiaoeeJaguHa'n2 222Cia... ,. .eatetfCiiaLbrtr,... UiaoptlXzodclCl LLG, insuia30 00, HN, 2ThCiiaeiaoeeoajndclUiest, INSA, N10 009, Cia E lnclMdclCl LlgfNnigMeianvriyJaguNg22hn) Absrc:0betvoepoeteeetoguoe (unuieekctseaets.nektesrt TatjcieTxlrhf FfcsflcsGl) ornluoyeetrsetadsehta... Egoeseteacrcfurayi.Mehs irekoyeadGlraueydy cmitymehd YtnurhcuayoinlsstodUrnayluctnuweemesrdbrhesrto ,. 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(韩国盈东... uriscanpro型尿液分析仪及配套尿... 11项试 条); 尿液质控品为上海伊华医学科技有限公司 产品; 镜检用olympusch.2显微镜和牛鲍氏计 数板; glu干粉 (ch no ?ho) 购自上海惠兴生 化试剂有限公司), 用时以双蒸水配成... 0.5g,ml (w,v) 的glu加入液; 30%. h0 (购自国药集团 化学试剂有限公司), When used with double distilled water diluted into 3%.. (V / V) H0, adding liquid. Two, urine detection method Take the disposable plastic urine cup to take the urine, after the straw mixes evenly, takes.. 10mL joined the graduated centrifuge tube, advanced dry chemical test, and so on 1500r / min centrifugation. After 5min, remove the supernatant and leave the precipitation 0.2mL, fully mixing and filling the liquid to the cow abalone count plate to high Double mirror count WBC, reference value see the literature. J, to men > 5 / L, female / >12 / L, WBC positive. WBC microscopy was positive and dry chemistry was negative for dry chemistry Feminine. All experiments were completed within 2h after sampling. Dried urine The chemical quality control method was carried out with reference to the literature [9]. Three. Retrospective data Yes, Huai'an Hospital Affiliated to Xuzhou Medical College. From September 2006 to... September 2007 urine Glu positive (including.. 4- - ~ + + + +) and WBC Microscopic examination of 220 cases of patients with positive (male to female ratio 4:6) urine test results A retrospective analysis was performed with urine, Glu negative, and WBC positive A total of 364 patients (male to female ratio of 4:6) served as controls. Four. Adding interference test Random urine test results. Only WBC dry chemical positive results. (including.. + +, + +, + + +) fresh urine, the level of 5. Copies of each serving, 2 tubes (lOmL per tube), were randomly divided into Glu group And HO addition group. . 1.Glu joined the trial in each sample of the Glu addition group Step in. Glu add liquid, so that the final concentration of Glu is in turn 8.33, 16.67, 38.89, 83.33, 166. 67mmol / L, relative The dry chemical grade respectively. +, +, + +, + + +, + + + +. In each step after adding reversed mixing, were 1 times of dry chemistry test immediately. Repeat with the test strip that removes the Glu module. . 2.HO2 accession test in HO: each sample added to the group In this process, H:O is added into the solution step by step, so that H:O: the final concentration is in turn For... 1.76, 5.29, 12.35, 24.7O, 44.12mmol / L, relative The dry chemical grade respectively, + +, + +, + + + + +, + + + +. In each step after adding reversed mixing, 1 dry chemical immediately.. Determination Five, statistical methods Statistical software for the comparison of SttfE92 rates AaS, Inspection. Multi group data is compared with... Kruskal - Wal LLIS rank sum Multiple comparisons between groups were made by using the Wilcoxon rank sum test The unconditional logistic regression was used for the quantitative relation analysis. Result One , Retrospective analysis.. 584 cases of WBC. Positive microscopic I clinical urine test data,. Glu grade WBC dry chemistry results were statistically different in each grade group Meaning Y- (x, =31.58, P=0.000). Group Glu+++ and Glu + + WBC + + + group. The false negative rate was higher than that of dry chemical Glu negative. Groups (=10.77, P=0.001, =24.62, P=0.000). See table 1. Table 1 dry chemistry results of WBC positive urine specimens Note: compared with the Glu negative group,... P<0.01 Two, Glu join test Different.. Glu concentration added to group urine.. WBC dry chemical positive The difference of detection number was statistically significant (X, =2) 22.438, P= 0.oo OO). Glu+++ group and.. Glu++++ group.. WBC drying The number of positive detection was lower than that of Glu negative group (P=0.004, P=) 0). See table 2. Logistic regression analysis suggested that WBC did The number of positive samples decreased with the increase of urine Glu concentration Potential ratio (OR) =0.10 00, P=0.0 000]. Remove the Glu module The test strip was repeated and similar results were obtained, u Gl+ + + + Group and Glu+++ + + group WBC dry chemical positive number are low In the Glu negative group (P=0.004, P=0.000). See table 3. Table 2 positive numbers of WBC dry chemistry at different Glu concentrations Taken Table 3 test strips for removing Glu modules at different Glu concentrations WBC positive number of dry chemistry Three, H2O: join the test Step in.. after HO, urine.. Glu dry chemistry result is grade Increment, hint: H:O: add success, see table 4. Different.. HO thick There were no statistically significant differences in positive numbers of WBC dry chemistry between the two groups 3L (x, =0.496, P=0.992). Table 4 positive numbers of WBC dry chemistry at different H:0 concentrations discuss Dry chemical assay of WBC is based on neutrophil cytoplasm Contains esterase that catalyzes the hydrolysis of indole esters with indole phenols and organic compounds Acids, indole, phenols can be further oxidized to indigo, or indole and heavy The principle that nitrogen salts react to form diazo pigments, and their color, depth, and grain What is the positive proportion of cells?. But lymphocytes and monocytes are fine The cytoplasm contains no esterase, so the method is only for granulocytes Sensitive to a certain percentage of false negatives. This study also proves that At this point, the false negative rate was 20.6% when urine Glu was negative. Dry chemistry and microscopic examination are 2 different kinds of There is no complete correspondence between the experimental methods of the principle. WBC result The report is judged by microscopy, while dry chemistry is for screening only, The positive grade does not contain more diagnostic value, therefore, for In Table 1, the WBC dry chemistry results are classified into 2 types, positive and negative. The results showed that the urinary Glu concentration was 83.33mmol / L (15, L) has apparently affected the dry chemical method of detecting WBC, making it It is not detected, and the degree of interference is increased with the increase of urine Glu concentration Increase, when urine Glu is "+ + + +", the false negative rate. 53.1%. Most authors think. "J, the false negative and urine. To Dan Kong Li plastic 24 dried LbrtreiieArl9vl4N4. AoaoyMdcn, pi20 00.... O2... O Glu, WBC, and dry chemistry are related simultaneously. Urine.. Glu determination One The enzyme method is used to produce reaction substances such as HO, which are the latter It inhibits the activity of esterase in the cytoplasm of leukocytes and interferes with the white pigment Cell esterase response, but the results of this study do not support this hypothesis. In the original, WBC dry chemically positive urine, add gradient concentration HO: after the dry chemistry test, the positive grade of Glu shows the ladder The degree of increase indicates that the added HO is well simulated by Glu oxidation Enzyme a peroxidase reaction, but WBC results did not appear obvious Change. In the Glu accession group, the number of positive WBC chemistry was counted Decrease with increasing Glu concentration, so it can be considered that... Glu pairs Urine.. WBC interference in dry chemical tests is not caused by... H, O. But in the enzymatic reaction that occurs on the Glu module, not more than H, O, One The formation of a product, in order to completely exclude.. Glu module reaction Effect, we will test on the Glu module removed after the.. Glu By adding the experiment, the results showed that the Glu itself interfered with the WBC drying The determination of the reaction product H, O, rather than the Glu module. . Glu is important for the interference of urine WBC dry chemical determination Clinical significance. Positive urine Glu is found in diabetic patients, Urine. WBc positive suggests urinary tract infection and urinary infection Diabetic patients are prone to complications, and diabetes mellitus is associated with complications Urinary infection in patients with about 40%, no symptoms Infection can cause further deterioration of glucose metabolism, often We become the reason of diabetic ketoacidosis. The results of this study When the urine showed that Glu reached. "+ + +", false negative WBC dry chemical Sex ratio has exceeded 45%. Therefore, these patients underwent urine at first visit Routine testing of fluids may cause urinary Glu interference and cause WBC drying The result is false negative, which results in urinary infection in diabetics Missed diagnosis. So, for urine.. WBC dry chemical tests are negative for sugar It is necessary to make a microscopic examination of urinary sediment in patients with urinary diseases. Reference Wang Haiyan, Hu Chengjin, Zhang Dechang Dry chemical method of white blood cell of false negative Sexual causes, [J]., Shaanxi medical laboratory, 20 000, 15 (1):37 -... Thirty-eight Han Ning, Zhang Daojie, Sun Li. The white fine urine urine analyzer The effect of stem cell chemical test results [J]. Journal of clinical laboratory,... 2005, 23 (2):154. Luo Liying. Urine white blood cells by the detection of chemical effects of urine [J]. Laboratory medicine and clinical medicine, 20 006, 3 (7):350. Wang Yuzhen. The urine test results of urine white blood cell chemical method. Ring. "[modern medical journal, 20 006, 21 (1):80. Yang Yan, Jia Lin, Jia Huilin. The white fine urine urine analyzer The impact of stem cell chemical testing, [J]. medical journal, 20 006, 27 (8):53. Wang Yujun, Yan Ruidi, Wan Nian, et al. The urine of diabetic patients is very thin RL One ]J Laboratory medicine, 20 009 years in April, twenty-fourth rolls, fourth wings.!!! Differential analysis of cell test results [J]. Shandong medicine, 20 006, 46 (34):54 - 55. [7] Zhao Hong, Wang Baoguang. The urine dry chemical urine analyzer white blood cell Impact of test results [J]. Journal of Qiqihar Medical School, 20 006,... 27fl8):2235. [8] al Ma Junlong, Deng Xinli bush, urine routine analysis of quality control. And clinical application. Journal of clinical laboratory [J]., 20 001, 19 (4):241-243. [9] bear. Make clinical examination based [M]. third edition. Beijing: People's health Sheng Sheng press, 20 005:189 - 190... (take up... On page 273.) Shu; Strong sheep dentatecrystallization: Main Gengzhi or slightly curved sides, dense long branch, The size of symmetry, fills the horizon, shiny; fern crystallization: Ye Zhongzhang. Loose, color all black, without luster; (2) ovulation cervical mucus: to dissolve Fern crystallization solution, grayish white, such as tide water, can see the hydrolysis The ferning, just to be replaced by the elliptical crystal. This period is momentary, See less; (3) after ovulation cervical mucus: just after ovulation, fern Not all the crystallization of hydrolysis, were only visible form arranged oval fern Crystalline, larger than white blood cells, with a certain transmittance. . 4. of the abnormal cervical mucus.. only 324 of the 785 patients met The above data, mostly for ovulation normal infertility patients. The remaining 461 cases of cervical adhesion There were different degrees of abnormalities in the fluid, including endocrine hormones and Gong Qiangcao Work, fatigue, and other mood changes, but endocrine hormone abnormalities Is the most important factor affecting cervical mucus. Yes. 7 Cervical mucus manifestation in 77 cases As the fern crystallization of strip shape, main stem slender dense, layered, some As many as 10 layers, each layer of fern crystallization leaves more and more fine, exciting Many suggest polycystic ovaries or elevated androgen levels alone. 138 patients The cervical mucus showed follicular oval fern crystallization has not returned, can To Wang and fern crystallization coexist, with multiple endocrine hyperprolactinemia or Corpus luteum atrophy. One 114 cases of cervical mucus mainly, slender and dense Fern crystallization sets, Branches short, such as broomlike, or sheep dentatecrystallization bending Song, light color, endocrine more than estrogen secretion, 43 cases of cervical mucus For small figure sheep dentatecrystallization exuberant, cauliflower, part of a cross Frame, occupying the full field of vision, and more than prompted the secretion of egg white hormone (FSH) inadequate. still There are 11 patients. The palace mouth closed, cervical mucus crystallization is few, check the fern Crystalline, with only a small amount of ellipsoidal crystalline, and ellipsoidal crystals surrounding the water Premature ovarian failure, pof. There were also 125 patients with cervical mucus in the platoon After the eggs for elliptic crystal is not full, mixed with Wang Wang fern or slightly Crystalline, partially ellipsoid, crystallized, surrounded by vacuoles, and some ellipses A small circular crystal, fine sand, not arranged in rows, or endocrine basis Silk! [10], Han Baoling, Han Jing, Zhang Fang, et al. Type.2 diabetes mellitus complicated with urinary tract diseases Clinical features and prevention and treatment of systemic infection in [J]. Chinese hospital infection Chi, 2007, 17 (9):1094, t095. Xiao Yuansong, Xu Wei. The elderly diabetes urinary tract infection clinical correlation Factor analysis, [J]., Journal of physician continuing education, 20 003, 26 (9B):39 -... Forty [12] Yoshizawa Yoshiko. Infection, prevention and treatment of diabetes mellitus [J]. Japanese medical introduction, 19 999, 20 (2):54 - 57... (received date: 806. Twenty 00-03) (Editor: Fan Jinong) Body temperature suggested luteal insufficiency. A variety of pathological cervical mucus tests Multiple endocrine examination results for the same person, The cervical mucus examination is also incomplete The same or similar, need careful smear, carefully identified. Three, discuss Cervical mucus is affected by endocrine estrogens and progesterone A change in phase. Atypical nodes arise in the following seventh days from the menstrual cycle Crystalline, more typical crystalline, typical crystallization during ovulation, followed by ovulation crystallization Gradually decreased, generally in the menstrual cycle, 22d no longer occurs crystallization, while in progesterone The ellipsoid appears under the influence of. There are many ways to monitor ovulation, such as basal body temperature, cervical mucus, and Yin Methods: the exfoliative cells, endometrial biopsy, endocrine determination, B-ultrasound and hysteroscopy were performed, Laparoscopy and other examinations, but each has its advantages and disadvantages. Endometrial biopsy and endocrine testing Hysteroscopy, hysteroscopy and laparoscopy are complicated and costly. They are difficult to duplicate and check repeatedly Check, and grass-roots hospitals are not universal; B ultrasound is often due to technical reasons, flatulence or Other factors cause the ovary to be unclear and cause missed diagnosis; the basal body temperature is higher For simple, but daily measurement, patients can not adhere to. And cervical mucus test Check convenient and economic, patients without any pain, easy to be accepted by both doctors and patients, for women Physicians have a good way of monitoring ovulation and studying ovarian function. But need to take The material is correct, the observer is careful, careful, and detailed records are taken to compare the views Observation, and should be good at research and summary, rely on years of experience, will experience. One In general, estrogen determination can be used to observe the function of the ovary and placenta, And the determination of progesterone can tell whether ovulation or not. Visible, cervical mucus Typical crystallization of smear, Many indicated the approximate ovulation time, for the infertile patient Directive significance. Amenorrhea, such as persistent typical crystallization, suggests oestrogen Too high; if there is no crystallization or only atypical crystallization, mostly estrogen Low. If the ellipsoid smear all rows continuously, without the fern. Crystalline appearance is a pregnancy phenomenon. Early pregnancy, if seen atypical crystallization, indicating that there is Threatened abortion may. . (received date: 090109 20--) (Editor: Fan Jinong)