摘要目的:通过评价干化学的白细胞酯酶和尿沉渣中的白细胞数（WBC）、鳞状上皮细胞数（SEC）数、细菌（BACT）数、鳞状上皮数/白细胞数（S/W）的值在尿液污染和感染中的意义，为临床提供鉴别诊断依据。方法:回顾性分析泰州市中医院2020年1—12月门诊和住院的女性患者尿液感染和污染患者各60例的临床资料，选取尿沉渣检测中的WBC、SEC、S/W、BACT及干化学法的白细胞酯酶五项指标两组间进行比较，并对WBC、SEC和S/W、BACT四个指标进行受试者工作特征（ROC）曲线分析。结果:通过比较污染组与感染组的WBC、SEC、S/W、BACT和白细胞酯酶检测结果，采用两独立样本非参数检验，比较结果显示，污染组标本中的WBC中位水平低于感染组[58.00（28.00 ~ 102.00）个/μl比329.00（145.00 ~ 775.50）个/μl]，差异有统计学意义（ Z = -7.03， P<0.01）；污染组标本中的SEC中位水平、S/W的中位水平和BACT的中位水平均高于感染组[43.00（16.25，73.75）个/μl比5.00（3.00，12.00）个/μl、0.620（0.285，1.209）比0.018（0.007，0.037）、21.00（6.25，78.50）个/μl比204.50（22.50，816.75）个/μl]，差异均有统计学意义（ P<0.01）；两组标本中的白细胞酯酶比较差异无统计学意义（ χ2 = 1.37， P = 0.24），将WBC、SEC、S/W、BACT进行ROC曲线绘制，结果显示四个指标对于鉴别污染与感染均具鉴别有意义，差异均有统计学意义（ P<0.01）。 结论:阴道分泌物会对尿液的白细胞酯酶、WBC、SEC、BACT的检测产生影响，其中WBC、SEC、S/W、BACT可作为尿液感染与尿液污染的鉴别诊断指标，同时可选择S/W来作为尿液污染的鉴别指标。

abstractsObjective:To evaluate the significance of the white blood cells count (WBC), squamous epithelial cells count (SEC), bacteria count (BACT), the ratio of squamous epithelial cells count and white blood cells count (S/W), and the examination of leukocyte esterase by dry chemical method in urine contamination and infection.Methods:A total of 60 cases of urine infection and 60 cases of urine contamination in female outpatients and inpatients in Taizhou Hospital of Traditional Chinese Medicine from January to December 2020 were retrospectively analyzed. The five indexes of WBC, SEC, S/W, BACT and leucocyte esterase were compared between the two groups, WBC, SEC, S/W and BACT were analyzed by receiver operating characteristic (ROC).Results:By comparing the detection results of WBC, SEC, S/W, BACT and leukocyte esterase between the contaminated group and the infected group, using the nonparametric test of two independent samples, the results showed that the median level of WBC in the contaminating group specimens was lower than in the infected group: 58.00 (28.00, 102.00)/μl vs. 329.00 (145.00, 775.50)/μl, the difference was statistically significant ( Z = -7.03, P<0.01). The median level of SEC, S/W and BACT in the contaminated group were higher than those in the infected group: 43.00 (16.25, 73.75)/μl vs. 5.00 (3.00, 12.00)/μl, 0.620 (0.285, 1.209) vs. 0.018 (0.007, 0.037), 21.00 (6.25, 78.50)/μl vs. 204.50 (22.50, 816.75)/μl, and the differences were all statistically significant ( P<0.01). There was no significant difference in the results of leukocyte esterase between the two groups ( χ2 = 1.37, P = 0.24). The ROC curves of WBC, SEC, S/W, BACT were drawn, and the results showed that the four indexes had statistical significance in distinguishing pollution from infection ( P<0.01). Conclusions:Vaginal secretion will affect the detection of leukocyte esterase, WBC, squamous epithelial cells and bacteria in urine. WBC, SEC, S/W and BACT can be used as the differential diagnosis indexes of urine infection and urine contamination, and S/W can be selected as the differential diagnosis index of urine contamination.