化学显色法和胶体金免疫法对粪便隐血检测准确性的比较  

Comparison of accuracy of fecal occult blood test by chemical staining method and colloidal gold immunoassay

作　　者：衡素景 HENG Sujing(Huanghe Central Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]黄河中心医院,河南郑州450003

出　　处：《中国医学工程》2020年第11期61-64,共4页China Medical Engineering

摘　　要：目的探讨化学显色法和胶体金免疫法对粪便隐血检测准确性的比较。方法选取2018年2月至2019年2月黄河中心医院325例粪便样本作为研究对象,经内镜检查上消化道出血108例(A组),下消化道出血77例(B组),无消化道疾病的常规粪便样本140例(C组)。比较三组粪便隐血试验检测结果,两种方法对粪便隐血的筛检效率,以及两种隐血试验检测人全血血红蛋白(Hb)灵敏度差异。结果化学显色法在A组和C组中的阳性检出率显著高于胶体金免疫法(P<0.05),在B组中阳性检出率显著低于胶体金免疫法(P<0.05);化学显色法及胶体金免疫法对粪便隐血检测的灵敏度分别为83.78%、82.16%,特异度为89.29%、97.86%,准确率为86.15%、88.92%,阳性预测值为91.18%、98.06%,阴性预测值为80.65%、80.59%,Kappa值为0.721、0.780;化学显色法的灵敏度为10μg/mL,胶体金免疫法的灵敏度为0.1μg/mL,Hb浓度>1000μg/mL时胶体金免疫法灵敏度下降。结论化学显色法检测和胶体金免疫法对于消化道不同出血位置的检测具有各自优势,可结合两种检测方法对粪便隐血进行辅助诊断。【Objective】To investigate the accuracy of chemical staining method and colloidal gold immunoassay for fecal occult blood test.【Methods】A total of 325 stool samples from the hospital collected from February 2018 to February 2019 were selected as subjects.One hundred and eight cases of upper gastrointestinal hemorrhage(group A),77 cases of lower gastrointestinal hemorrhage(group B)and 140 cases of conventional stool samples without digestive tract disease(group C)were examined by endoscopy.Results of fecal occult blood tests in the three groups were compared.The screening efficiencies of the two methods for fecal occult blood and sensitivities for detection of whole blood Hb were compared.【Results】The positive rates of chemical staining method in group A and group C were significantly higher than those of colloidal gold immunoassay(P<0.05),while the positive detection rate in group B was significantly lower than colloidal gold immunoassay(P<0.05).The sensitivities,specificities,accuracy rates,positive predictive values,negative predictive values and kappa values of fecal occult blood test by chemical staining method and colloidal gold immunoassay were 83.78%and 82.16%,89.29%and 97.86%,86.15%and 88.92%,91.18%and 98.06%,80.65%and 80.59%,and 0.721 and 0.780,respectively.The sensitivities of chemical staining method and colloidal gold immunoassay were 10μg/mL and 0.1μg/mL,respectively.When the concentration of Hb was higher than 1000μg/mL,the sensitivity of colloidal gold immunoassay decreased.【Conclusion】Chemical staining method and colloidal gold immunoassay have their own advantages for detection of different bleeding sites in the digestive tract.Two methods can be combined to diagnose the occult blood in the digestive tract.

关 键 词：化学显色法 胶体金免疫法 粪便隐血 阳性 

分 类 号：R446.13[医药卫生—诊断学]