Abstract: Objective To compare the value of multiple urine detection methods in urinary tract infection by Meta analysis, including bacterial culture, urinary sediment microscopic examination, urine analyzer and routine urine dry chemical method for bacteria, white blood cell and red blood cell.Methods The papers were retrieved from PubMed, EMbase, Cochrane library, Springerlink, CNKI and Wanfang database, with the time limit of retrieval from the establishment of database to December, 2014. Two system evaluators performed independent screening for the quality of references according to the inclusion and exclusion criteria in references. RevMan 5.3 and Meta-DiSc were adopted for reference analysis. The combination sensitivity (Sen), specificity (Spe), positive likelihood ratio (LR⁺), negative likelihood ratio (LR^-) and diagnosis odds ratio (DOR) were calculated, and SROC curve was drawn.Results ① 14 references were included finally (the information of 9 518 patients in total) according to the inclusion and exclusion criteria ; ② urine while blood cell were detected by urinary sediment microscopic examination as the golden standard; according to the detection by the routine urine dry chemical method, the AUC (area under the curve) of SROC is 0.9656, the comprehensive sensitivity was 0.845 (0.805,0.879), and the comprehensive specificity 0.944(0.929,0.957); according to the detection by the urine analyzer, the AUC of SROC was 0.8983, the comprehensive sensitivity 0.631 (0.591,0.669), and the comprehensive specificity 0.929 (0.911,0.944); ③ urine red blood cell was detected by urinary sediment microscopic examination as the golden standard; according to the detection by the routine urine dry chemical method, the AUC of SROC was 0.9306, the comprehensive sensitivity 0.590 (0.572,0.608), and the comprehensive specificity 0.948 (0.938,0.956); according to the detection by the urine analyzer, the AUC of SROC was 0.7319, the comprehensive sensitivity 0.473 (0.433,0.513), and the comprehensive specificity 0.971 (0.958,0.980); ④ Urine bacteria were detectedby bacterial culture as the golden standard; according to the urine analyzer, the AUC of SROC curve fitting was 0.9048, the comprehensive sensitivity 0.842 (0.811,0.870), and the comprehensive specificity 0.881 (0.865,0.896).Conclusion In the examination of white blood cell and red blood cell under urinary tract infection, the routine urine dry chemical method was superior to urine analyzer in terms of AUC, sensitivity and specificity. In the urine bacterial examination, urine analyzer had higher diagnostic values and a shorter period of bacterial culture. Therefore, urine analyzer was recommended for screening of urine bacteria. However, in order to make a definite diagnosis, it was necessary for the combination of bacterial culture.

Key words: urinary tract infections, meta-analysis, bacterial culture, urinary sediment microscopic examination, urine analyzer, routine urine dry chemical method