粪便转铁蛋白试验在提高消化道出血检出率中的作用

Effects of faeces transferrin proving test in improving the detected ratio in gastrointestinal bleeding

目的研究粪便转铁蛋白试验(TFPT)与免疫粪隐血试验(IFOBT)互补的可行性,以提高消化道出血的检出率。方法连续性收集接受胃镜或结肠镜检查患者的粪便,其中上消化道出血性疾病27例,上消化道非出血性疾病31例;下消化道出血性疾病30例,下消化道非出血性疾病16例。分别计算IFOBT和TFPT的敏感性、特异性、阳性预示值、阴性预示值,再计算转铁蛋白试验与粪隐血试验的互补率。结果在上消化道出血性疾病中,TFPT的敏感性(8/27)显著高于IFOBT(2/27)(P<0.05)。在下消化道出血性疾病中,TFPT的敏感性(25/30)也显著高于IFOBT(16/30)(P<0.05)。两个试验结合互补后,将上、下消化道出血检出率分别提高到29.6%和83.3%。结论无论是上消化道出血还是下消化道出血,转铁蛋白试验的敏感性均高于免疫粪隐血试验。两个试验结合互补可明显提高消化道出血的检出效率。

Objective To study the feasibility of combination of immune faeces occult blood test（IFOBT） and transferrin proving test（TFPT）,and to improve the detected ratio in gastrointestinal hemorrhage.Methods These patients＇ faeces,who were undergoing gastroscopy or coloscopy were collected continuously.Twenty-seven suffered from upper gastrointestinal bleeding,30 suffered from lower gastrointestinal bleeding,47 without alimentary tract hemorrhage diseases.Then,the sensitivity,specificity,positive predictive value,negative predictive value of IFOBT and TFPT were separately calculated.Finally,the complementation rate was calculated in IFOBT and TFPT.Results In upper gastrointestinal bleeding diseases,the sensitivity was higher by TFPT（8/27） than that by IFOBT（2/27）（P〈0.05）.In lower digestive tract bleeding diseases,the result was same（25/30 by TFPT to 16/30 by IFOBT）（P〈0.05）.After combining the two methods,the detected ratio was improved to 29.6% in upper gastrointestinal bleeding diseases,while it was 83.3% in lower digestive tract bleeding diseases.Conclusion The sensitivity of TFPT is better than IFOBT in detecting both upper gastrointestinal bleeding diseases and lower digestive tract bleeding diseases.Combining the two methods,we can improve the detected ratio of gastrointestinal hemorrhage diseases.