三种隐血检测法的方法学评价及结果分析  

Evaluation and analysis of three methods of occult blood test

作　　者：李月[1] 代震宇[2] 廖方洪 Li Yue;Dai Zhengyu;Liao Fanghong(Department of Clinical Laboratory,the Second Affiliated Hospital,Chongqing Medical University;Department of Orthopedics,Chongqing Traditional Chinese Medicine Hospital;Department of Laboratory,Beibei Traditional Chinese Medicine Hospital)

机构地区：[1]重庆医科大学附属第二医院检验科,重庆400014 [2]重庆市中医院骨科,重庆400021 [3]重庆市北碚区中医院检验科,重庆400711

出　　处：《重庆医科大学学报》2018年第9期1212-1216,共5页Journal of Chongqing Medical University

摘　　要：目的:对血红蛋白单克隆抗体免疫胶体金法、血红蛋白与转铁蛋白联合免疫法、匹拉米洞化学法3种隐血检测法进行方法学评价,找出高临床符合度的隐血检测方法。方法:配制不同浓度的血红蛋白液,测出以上3种方法的最低检出限与最高检测浓度;利用5种常见动物的抗凝血评价隐血检测方法的特异性;收集住院患者粪便和胃液标本同时进行3种方法的隐血检测,内镜检查为金标准,计算临床灵敏度、临床特异性、阴性似然比、阳性似然比、尤登指数、临床符合率。结果:凯创试剂卡胶体金的检测范围为200 ng/m L至10 mg/m L,沃文特试剂卡胶体金的检测范围为300 ng/m L至2.5 mg/m L,匹拉米洞化学法的最低检测限为2 500 ng/m L,联合免疫法的最低检测限为10 ng/m L;凯创试剂卡胶体金、沃文特试剂卡胶体金、匹拉米洞化学法、联合免疫法检测粪便与胃液隐血临床符合率分别为96.0%、95.8%、79.5%、97.5%;92.9%、92.9%、94.6%、90.2%。粪便隐血检测的结果,4组间有明显的差异(P=0.000),但胃液隐血检测结果组间无差异(P=0.083)。结论:粪便标本的隐血检测,联合免疫法的临床符合度优于血红蛋白免疫法,血红蛋白免疫法优于化学法;胃液标本的隐血检测,3种方法之间无明显差异。Objective：To evaluate hemoglobin monoclonal antibody immune colloidal gold method,hemoglobin and transferrin combined immunoassay,pyramidon chemical method for occult blood detection and to identify occult blood detection method consistent with clinical practice. Methods：Hemoglobin solutions of different concentrations were prepared,and the minimum detection limit and the highest test concentration of the three methods were checked. The specificity of these threeoccult blood testing methods was evaluated with five kinds of animal blood. Feces and gastric juice specimens of hospitalized patientswere collected for three kinds of meth-ods of occult blood test. With endoscopy as the gold standard,the sensitivity,specificity,negative and positive likelihood ratio,and Youden index clinical coincidence rate were calculated. Results：Examination area of Kaichuang and Oritent was 200 ng/m L to 10 mg/m L,and 300 ng/m L to 2.5 mg/m L,respectively. The minimum detection limit ofpyramidon chemical method and combined immunoassaywas2 500 ng/m L and 10 ng/m L. The clinicalcoincidence rates of Kaichuang,Oritent,pyramidon chemical method,combined immunoassay in feces and gastric juice were respectively 96.0%,95.8%,79.5%,97.5% and 92.9%,92.9%,94.6%,90.2%. There were obvious differences in fecal occult blood test results between the four groups（P=0.000）,but no difference was observed in the gastric occult blood detection results between groups（P =0.083）. Conclusion：For fecesoccult blood test,combined immunoassay is superior to hemoglobin immunization,hemoglobin immune method is better than the chemical method.For occult blood detection of gastric juice specimens,there is no significant difference among the three methods.

关 键 词：隐血 消化道出血 匹拉米洞法 血红蛋白 转铁蛋白 

分 类 号：R446.133[医药卫生—诊断学]