血清尿素氮联合双联法便潜血检测在上消化道出血中的诊断价值  

Diagnostic value of serum blood urea nitrogen combined with dual detection of fecal occult blood in upper gastrointestinal bleeding

作　　者：邓开清 杨笑琼 DENG Kaiqing;YANG Xiaoqiong(Department of Blood Transfusion,the First Dongguan Affiliated Hospital of Guangdong Medical University,Guangdong Province,Dongguan 523710,China)

机构地区：[1]广东医科大学附属东莞第一医院输血科,广东东莞523710

出　　处：《中国当代医药》2025年第2期104-107,共4页China Modern Medicine

摘　　要：目的分析血清尿素氮(BUN)联合双联法便潜血检测在上消化道出血(UGB)中的诊断价值。方法选择2021年1月至2023年12月于广东医科大学附属东莞第一医院治疗的100例UGB患者及100例下消化道出血患者分别作为UGB组与下消化道出血组,同时选取同期于广东医科大学附属东莞第一医院体检的100名体检健康者作为对照组。采集三组研究对象的空腹静脉血及粪便样本,检测血清BUN水平、粪便中血红蛋白(Hb)及转铁蛋白(Tf)。比较三组的BUN水平,计算双联法便潜血、BUN,以及二者联合诊断UGB的敏感度、特异度、准确度,及与胃镜检查结果的一致性。结果UGB组的BUN水平高于下消化道出血组与对照组,差异有统计学意义(P<0.05);下消化道出血组与对照组的BUN水平比较,差异无统计学意义(P>0.05);双联法便潜血联合BUN检测诊断UGB敏感度为90.00%、特异度为86.50%、准确度为87.67%,均高于双联法便潜血(74.00%、73.50%、73.67%)、BUN(76.00%、73.00%、74.00%)单一检测;双联法便潜血联合BUN检测诊断UGB结果与胃镜检查结果一致性(kappa=0.734,P<0.001)优于双联法便潜血(kappa=0.445,P<0.001)与BUN(kappa=0.456,P<0.001)。结论血清BUN联合双联法便潜血检测利于鉴别诊断UGB,可鉴别消化道出血部位,为UGB诊断及治疗提供指导。Objective To analyze the diagnostic value of serum blood urea nitrogen(BUN)combined with dual detection of fecal occult blood in upper gastrointestinal bleeding(UGB).Methods A total of 100 patients with UGB and 100 patients with lower gastrointestinal bleeding treated in the First Dongguan Affiliated Hospital of Guangdong Medical University from January 2021 to December 2023 were selected as UGB group and lower gastrointestinal bleeding group,respectively.At the same time,100 healthy people who underwent physical examination in the First Dongguan Affiliated Hospital of Guangdong Medical University during the same period were selected as control group.Fasting venous blood and fecal samples were collected from the three groups,and the serum BUN level,fecal hemoglobin(Hb)and transferrin(Tf)were detected.The BUN levels of the three groups were compared,and the sensitivity,specificity,accuracy of the dual detection of fecal occult blood,BUN,and the combination of the two in the diagnosis of UGB were calculated,as well as the consistency with the results of gastroscopy.Results The BUN level of UGB group was higher than those of lower gastrointestinal bleeding group and control group,and the differences were statistically significant(P<0.05).There was no significant difference in BUN level between the lower gastrointestinal bleeding group and the control group(P>0.05).The sensitivity,specificity and accuracy of dual detection of fecal occult blood combined with BUN detection in the diagnosis of UGB were 90.00%,86.50%and 87.67%,which were higher than those of dual detection of fecal occult blood(74.00%,73.50%,73.67%)and BUN(76.00%,73.00%,74.00%)single detection.The consistency between the results of dual detection of fecal occult blood combined with BUN and gastroscopy in the diagnosis of UGB(kappa=0.734,P<0.001)were better than those of dual detection of fecal occult blood(kappa=0.445,P<0.001)and BUN(kappa=0.456,P<0.001).Conclusion Serum BUN combined with dual detection of fecal occult blood is helpful for the different

关 键 词：上消化道出血 尿素氮 双联法便潜血检测 一致性 

分 类 号：R446.1[医药卫生—诊断学]