三种检测方法在胃液隐血试验中的临床应用评价

目的探讨并评价转铁蛋白法、血红蛋白胶体金法、化学法测定胃内容物隐血的临床应用价值。方法随机对103例患者胃液同步使用检测转铁蛋白(TF)法、血红蛋白胶体金法和化学法进行检测。以内窥镜检测为金标准，探讨三种方法的灵敏度及特异度。结果化学法灵敏度(阳性率)为35.9%，特异度为36.0%；血红蛋白胶体金法灵敏度(阳性率)为41.0%，特异度为72.0%；转铁蛋白法灵敏度(阳性率)为52.7%，特异度为76.0%，转铁蛋白法优于化学法和血红蛋白胶体金法，差异有统计学意义(χ2=19.466，P<0.05；χ2=9.346，P<0.05)。转铁蛋白法和血红蛋白胶体金法联合应用灵敏度(阳性率)为62.8%，特异度为84.0%。结论检测胃液隐血时转铁蛋白法优于化学法和血红蛋白胶体金法，联合应用转铁蛋白法和血红蛋白胶体金法检测更符合临床诊断，是筛检胃内容物隐血更理想的新方法，值得推广。

Clinical Application of Gastric Juice Occult Blood Detected by Three Detection Methods

ObjectiveTo explore and evaluate the application value of occult blood in gastric juice detected by transferring method，hemoglobin colloidal gold method and chemical method．Methods103 patients were chosen randomly for detection of gastric juice by transferrin method，hemoglobin colloidal gold method and chemical method．Occult blood in gastric juice was diagnosed by endoscopy，a gold standard method．Then evaluated the sensitivity and specificity of three methods．ResultsChemical method(positive rate) sensitivity was 35.9%，and specificity was 36.0%．Hemoglobin colloidal gold method sensitivity (positive rate) was 41.0%，and specificity was 72.0%．Transferrin method sensitivity (positive rate) was 52.7%，and specificity was 76.0%．Transferrin method was superior to the chemical method and hemoglobin colloidal gold method，the difference was statistically significant (χ2=19.466，P<0.05；χ2=9.346，P<0.05)．Transferrin and hemoglobin colloidal gold method combined use of sensitivity (positive) was 62.8%，and specificity was 84.0%．ConclusionDetection of occult blood in gastric juice transferrin method was superior to the chemical method and hemoglobin colloidal gold method．The combined transferrin／hemoglobin colloidal gold method which detected both transferrin and hemoglobin gastric juice was a good and new method for screening hemorrhage of gastric juice．It is worth further application．