3种粪便隐血试剂的实验评估及影响因素探讨

目的 比较3种不同品牌的免疫胶体金粪便隐血试纸条敏感性、特异性、干扰试验检测结果,了解和探讨免疫胶体金潜血试剂的优缺点及影响因素.方法 使用不同浓度的血红蛋标准液对3种隐血试纸条的灵敏度进行比对测定;选取中山市古镇医院本院消化科确诊上消化道出血患者粪便标本25例；下消化道出血患者粪便标本50例,体检中心健康体检者粪便标本60例,对3种隐血试纸条进行临床标本验证试验;采用8种动物抗凝血、4种不同浓度维生素C、5种不同浓度过氧化物酶、铁剂对这3种隐血试纸条进行干扰试验.结果 3种试剂条的最低敏感度血红蛋白均达到0.18 μg/mL,干扰试验结果显示均为阴性；在临床标本验证实验结果中,健康体检者的粪便标本检测结果均为阴性.结论 对高度怀疑上、下消化道出血的患者,胶体金试纸条检测结果为阴性的临床标本,建议稀释该标本或使用其他方法进行复测.

Experimental assessment and interferential factors of three fecal occult blood reagents

Objective To compare the sensitivity, specificity, and the interference results of three different brands of immune colloidal gold fecal occult blood test strips（FOBTs）,and then to discuss the advantages, disadvan- tages and interferential factors of the immune colloidal gold reagents. Methods To determine and compare the sensi- tivities of three FOBTs with different concentrations of hemoglobin solution. To make the clinical tests on three kinds of FOBTs with 25 fecal smears from the ~atients diagnosed upper gastrointestinal bleeding, 50 from lower ones, 60 from health examinationers in Guzhen hospital; to make the interference experiments on FOBTs with 8 types of animalrs anticoagulant,4 different concentrations of vitamin C, 5 different concentrations of peroxidase and iron. Results The lowest sensitivity of three FOBTs for hemoglobin was all 0. 18 txg/mL. The interference experimental and clinical results all showed negative, but about 10 ~ smears in upper gastrointestinal bleeding were still not found negative. Conclusion For patients with highly doubted upper and lower gastrointestinal bleeding and whose smears showing negative in colloidal gold test strips, it is recommended that the results should be checked again through diluting the smears or other methods.