Parsa Tania, Cunningham Sandra J, Wall Stephen P, Almo Steven C, Crain Ellen F
Department of Pediatrics Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Am J Emerg Med. 2005 Oct;23(6):787-92. doi: 10.1016/j.ajem.2005.02.051.
To evaluate urine fluorescence as a diagnostic tool.
Using a Wood lamp, 60 physicians, assigned to group 1 or 2, independently rated 150 urine specimens from nonpoisoned children as fluorescent or nonfluorescent. Interobserver and intraobserver agreements were assessed. Physician ratings were compared with fluorometry results. The prevalence of urine fluorescence was determined by fluorometry.
Group 1 reported fluorescence in 80.7% (95% CI 73.4%-86.6%) of urine specimens; group 2 reported fluorescence in 69.3% (95% CI 61.3%-76.5%). Interrater agreement was poor (72.5%, kappa = 0.25, 95% CI 0.13-0.37); intrarater agreement was good (physician group 1: 97.9%, kappa = 0.93, 95% CI 0.77-1.00; physician group 2: 93.3%, kappa = 0.85, 95% CI 0.69-1.00). The prevalence of urine fluorescence was 100% (95% CI 98.1%-100%).
Our data suggest that determination of urine fluorescence using a Wood lamp is a poor screening tool for suspected antifreeze ingestion in children.
评估尿液荧光作为一种诊断工具的价值。
使用伍德灯，60名被分配到第1组或第2组的医生独立对150份来自未中毒儿童的尿液标本进行荧光或非荧光评级。评估观察者间和观察者内的一致性。将医生的评级与荧光测定结果进行比较。通过荧光测定确定尿液荧光的患病率。
第1组报告80.7%（95%可信区间73.4%-86.6%）的尿液标本有荧光；第2组报告69.3%（95%可信区间61.3%-76.5%）有荧光。评分者间一致性较差（72.5%，kappa = 0.25，95%可信区间0.13-0.37）；评分者内一致性良好（医生第1组：97.9%，kappa = 0.93，95%可信区间0.77-1.00；医生第2组：93.3%），kappa = 0.85，95%可信区间0.69-1.00）。尿液荧光的患病率为100%（95%可信区间98.1%-100%）。
我们的数据表明，使用伍德灯测定尿液荧光对于疑似儿童摄入防冻液而言是一种较差的筛查工具。
