临床三种常规大便隐血检测方法的评价及其应用  

Evaluation and Their Application of Three Kinds of Routine Clinical Detection Methods for Fecal Occult Blood

作　　者：袁乐永[1] 李艳[1] 徐万洲[1] 陈进[1] 吴泽刚[1] 

机构地区：[1]武汉大学人民医院检验科,武汉430060

出　　处：《现代检验医学杂志》2012年第2期73-76,共4页Journal of Modern Laboratory Medicine

摘　　要：目的时转铁蛋白（Tf）／血红蛋白（Hb）联合免疫法（联合免疫法）、血红蛋白单克隆抗体法（单克隆抗体法）和匹拉米洞法进行方法学比较并探讨三种大便隐血试验的临床应用价值。方法通过灵敏度与干扰性试验对三种大便常规检测实验方法学进行比较．并用三种试验方法同时对186例大便标本进行检测。结果联合免疫法、单克隆抗体法和匹拉米洞法血红蛋白（Hb）最低检出浓度分别为0．2，0．2和2bμg／ml，联合免疫法转铁蛋白最低检测浓度为0．04／μg／ml。匹拉米洞法能与人以及其他动物Hb反应，而单克隆抗体法和联合免疫法只能与人的Hb反应。一定浓度的vitC可遣成匹拉米洞法假阴性结果，而时另外两种试验方法的检测结果无影响。上消化道出血组三种方法检测阳性率分别为90．2％，74．5％和94．1％；下消化遗出血组三种方法检测阳性率分别为100．0％，96．3％和74．1％；正常对照组三种方法检测阳性率分别为6．5％，2．8％和10．2％。匹拉米洞法检测上消化道出血和下消化道出血组的阳性率分别为94．1％和74．1％。结论联合免疫法、单克隆抗体法与匹拉米洞法相互补充。相互结合对消化道出血性疾病检测有更高的临床诊断价值。Objective Comparing combined immunoassay of transferrin（Tf）/hem-oglobin（Hb）,monoclonal antibody method of hemoglobin and pyramidon method in methodology and discussing the clinical value of three kinds of fecal occult blood test. Methods Comparing three kinds of fecal occult blood test in methodology Through experiment of sensitivity and inter- ference,and also using three methods of test to detect occult blood for 186 cases stool speciments. Results The lowest de- tected concentration of combined immunoassay,monoclonal antibody method and pyramidon chemical method was 0. 2,0. 2 and 2 μg/ml for hemoglobin, respectively,and lowest detected concentration of combined immunoassay for transferrin was 0. 04 tμg/ml. Pyramidon method could react with Hb of human and other animals,however,monoclonal antibody method and combined immunoassay could only response with human Hb. A certain concentration levels of VitC could canse pyramidon false-negative results,while the other two test methods had no effect on the testresults. The detection rates were respectively 90. 2% ,74.5% and 94.1% in uppergastrointestinal bleeding group,then the rates were respectively 100. 0%,96.3% and 74.1 %/00 in lower gastrointestinal cancer group and also the rates of nomal control group were 6. 5~,2. 8% and 10. 2%, re- spectively,with combined immunoassay, monoclonal antibody method and pyramidon chemical method. The detection rates were 94.1 %/0 and 74.1%respectively with pyramidon method in upper gastrointestinal bleeding group and lower gastrointes- tinal cancer group. Conclusion It would have a higher diagnostic value to detect gastrointestinal bleeding disorders if there are well combination and complement among three kinds of methods.

关 键 词：大便隐血 转铁蛋白 血红蛋白 匹拉米洞法 

分 类 号：R446.133[医药卫生—诊断学]