■本研究的目的是评估血尿作为肾和输尿管结石的诊断测试,与急诊室急性腰痛患者的非对比增强计算机断层扫描(CT)扫描(金标准测试)进行比较。
■总共,从2006年到2011年在我们急诊科接受治疗的604例患者,有腰痛和可疑尿石症的病史,纳入回顾性研究。所有患者均采用非对比增强CT扫描和尿液分析进行评估。使用非对比CT扫描作为评估存在的金标准,number,尺寸,和部位(肾或输尿管[上,中间,和较低])的石头,我们计算了灵敏度,特异性,以及血尿对诊断肾结石和输尿管结石的阳性和阴性预测值。
■在非对比增强CT扫描中,388例患者(64%)和216例患者(36%)没有结石。敏感性,特异性,正预测值,微血尿的阴性预测值为77%,33%,67%,45%,分别。与仅有肾结石的患者(32例)相比,微血尿在仅有输尿管结石的患者(139例)中更为常见,敏感性为85%。灵敏度为55%(P<0.001)。特异性或阳性或阴性预测值没有显着差异。
■尽管微血尿对输尿管结石更敏感,没有微小血尿并不能排除尿石症的可能性,非对比增强CT扫描应该是金标准诊断工具.
UNASSIGNED: The objective of the study was to evaluate hematuria as a diagnostic test for renal and ureteral stones compared with a noncontrast-enhanced computed tomography (CT) scan (gold standard test) in emergency room patients with acute flank pain.
UNASSIGNED: In total, 604 patients treated in our emergency department from 2006 to 2011, with a history of flank pain and suspected urolithiasis were included in a retrospective review. All patients were evaluated with a noncontrast-enhanced CT scan and urine analysis. Using the noncontrast CT scan as the gold standard for the evaluation of the presence, number, size, and site (renal or ureteral [upper, middle, and lower]) of the stones, we calculated the sensitivity, specificity, and positive and negative predictive values of hematuria for diagnosing both renal and ureteral stones.
UNASSIGNED: Urolithiasis was diagnosed in 388 patients (64%) and 216 patients (36%) had no stones on a noncontrast-enhanced CT scan. The sensitivity, specificity, positive predictive value, and negative predictive value for microhematuria were 77%, 33%, 67%, and 45%, respectively. Microhematuria was more common in patients with ureteral stones only (139 patients) and had a sensitivity of 85% compared to patients with renal stones only (32 patients), with a sensitivity of 55% (P < 0.001). There were no significant differences in the specificity or positive or negative predictive values.
UNASSIGNED: Although microhematuria is more sensitive to ureteral stones, the absence of microhematuria does not exclude the possibility of urolithiasis and a noncontrast-enhanced CT scan should be the gold standard diagnostic tool.