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目的免疫法和化学法粪便潜血试验在上、下消化道出血性疾病中的应用价值的比较研究。方法分别对消化道出血病人粪便、血红蛋白液与三种消化液孵育的吸收光谱进行观察并记录潜血结果,同时采用两种方法对149例经临床确诊的不同类型消化道出血病人和340例体检人群粪便进行潜血检测,以评价两种粪便潜血试验结果。结果上消化道出血病人粪便有一不规则梯形吸收峰;血红蛋白液与三种消化液孵育后,免疫法粪便潜血试验呈阴性结果;两种方法检测56例上消化道出血病人粪便潜血,免疫法阳性率明显低于化学法(χ2=36.02,P<0.01),对48例下消化道出血病人,免疫法阳性率高于化学法(χ2=4.90,P<0.05)。结论免疫法应用于上消化道出血性疾病的诊断应慎重,应将两种方法列为大便常规检查和体检普查项目。
Objective To compare the clinical value of fecal occult blood test with chemical and chemical methods in upper and lower gastrointestinal bleeding diseases. Methods The absorption spectra of excrement, hemoglobin and digestive juice incubated in patients with gastrointestinal bleeding were observed and the occult blood was recorded. Two methods were used to analyze 149 cases of clinically diagnosed gastrointestinal bleeding and 340 cases of physical examination Fecal occult blood test to evaluate two fecal occult blood test results. Results There was an irregular trapezoidal absorption peak in the excrement of patients with upper gastrointestinal bleeding. After incubating the hemoglobin solution with three digestive fluids, the faecal occult blood test by immunological method showed negative results. The fecal occult blood of 56 patients with upper gastrointestinal bleeding was detected by two methods and was positive by immunization (Χ2 = 36.02, P <0.01). The positive rate of immunohistochemistry in 48 cases of lower gastrointestinal bleeding was higher than that of the chemical method (χ2 = 4.90, P <0.05). Conclusion The application of immunoassay in the diagnosis of upper gastrointestinal bleeding should be cautious, and the two methods should be classified as routine stool examination and physical examination.