Ochoa Sangrador C, Conde Redondo F
Servicio de Pediatría. Hospital Virgen de la Concha. Zamora. España.
An Pediatr (Barc). 2007 Nov;67(5):450-60. doi: 10.1016/s1695-4033(07)70712-9.
A review of the scientific evidence available on the validity of urinalysis in the diagnosis of urinary tract infection in childhood is presented. Numerous studies evaluating the validity of distinct urinalysis parameters have been published. Although many of these studies have methodological deficiencies, the indicators of validity evaluated in the various systematic reviews can be assumed to be applicable to clinical practice; however, the grade of evidence supporting these studies is less than optimal. There are some parameters or combinations of parameters that have better sensitivity or specificity, but few present sufficiently high positive and negative predictive values simultaneously to form the exclusive basis for diagnosis. Bacteriuria presents certain advantages over other parameters, although this test is not routinely available and loses validity in non-sterile samples. Nevertheless, there are several circumstances that can modify the applicability of these tests in clinical practice: the technique used in urine collection, the patient's age and clinical status, and especially the degree of urgency with which the diagnosis is required.
本文对现有关于儿童尿路感染诊断中尿液分析有效性的科学证据进行了综述。已发表了许多评估不同尿液分析参数有效性的研究。尽管其中许多研究存在方法学缺陷，但在各种系统评价中评估的有效性指标可被认为适用于临床实践；然而，支持这些研究的证据等级并非最佳。有一些参数或参数组合具有更好的敏感性或特异性，但很少有同时具有足够高的阳性和阴性预测值以构成诊断的唯一依据。菌尿症相对于其他参数具有一定优势，尽管该检测并非常规可用，且在非无菌样本中会失去有效性。然而，有几种情况会改变这些检测在临床实践中的适用性：尿液收集所采用的技术、患者的年龄和临床状况，尤其是对诊断的迫切程度。
