化学法和免疫法粪隐血试验对中老年人消化道出血的筛查价值

Chemical and Immunization Methods in Fecal Occult Blood Test (FOBT) in Middle-aged and Old-aged Patients with Alimentary Tract Hemorrhage:Screening Significance

目的探讨化学法及免疫法两种粪隐血试验对中老年人消化道出血的筛查价值。方法采用化学法(CFOBT)及免疫法(IFOBT)粪隐血试验对1159例军队中老年干部(军队组)和3585例地方中老年人(地方组)进行筛检,结果阳性者进一步检查确诊,比较两种方法的检测结果。结果①军队组与地方组粪隐血试验阳性分别是144例(12.4%)和246例(6.9%),其中CFOBT阳性为63例(43.7%)和227例(92.3%);IFOBT阳性为118例(81.9%)和109例(44.3%),而双项检查法均阳性分别为37例(25.7%)和90例(36.6%);军队组与地方组诊断为上消化道出血分别有62例(43.1%)和173例(70.3%),下消化道出血分别为82例(56.9%)和54例(22.0%)。②两组上消化道出血阳性率CFOBT高于IFOBT,差异有统计学意义(P<0.01);下消化道出血阳性率IFOBT高于CFOBT,差异有统计学意义(P<0.01或0.05);CFOBT诊断下消化道出血,地方组阳性率比军队组高(P<0.05)。结论诊断上消化道出血CFOBT优于IFOBT;诊断下消化道出血IFOBT优于CFOBT。同时采用两种粪隐血试验筛查消化道隐性出血及相关疾病有重要临床意义。

Objective To discuss screening significance of chemical and immunization methods in Fecal Occult Blood Test （FOBT） in middle-aged and old-aged patients with alimentary tract hemorrhage. Methods 1159 middle and old-aged patients from PLA and 3585 civilian patients took Hemoccult II（CFOBT） and Colloidal Gold Chromagraphy fecal occult blood tests （IFOBT） simultaneously. Patients with positive results were further examined and diagnosed and results were compared. Results The FOBT positive rates of the PLA group and the civiliand group were 12.4% （n = 114） and 6.9% （n =246）, including 63 cases （43.7%） and 227 cases （92.3%） CFBOT positive; 118 cases （81.9%）and 109 cases （44. 3% ） IFOBT positive. Patients showing positive in both tests were 37 （25.7%） and 90 （36.6%）. but there were 62 cases （43.1%） and 173 cases （70. 3% ） of upper gastrointestinal bleeding and 82 （56. 9% ） and 54 （22.0%） of lower gastrointestinal bleeding, the ratio of the upper gastrointestinal bleeding in PLA group was higher than that in civiliand group （P 〈0. 05）, and the ratio of the lower gastrointestinal bleeding was lower than that of civiliand group （P 〈0. 05）. The positive rates of CFOBT of patients with upper gastrointestinal bleeding in both groups were higher than that of IFBOT with significant difference （ P 〈 0. 01 ）, but IFBOT had higher rates than CFBOT in patients with lower gastrointestinal bleeding （P 〈 0. 01 or 0. 05）. The PLA group had a lower positive rate of lower gastrointestinal hemorrhage than the civilian group （P 〈 0. 05）. Conclusion In diagnosis of upper gastrointestinal bleeding,CFBOT is better than IFBOT, while in diagnosis of lower gastrointestinal bleeding, IFBOT is better than CFBOT. Simultaneous conduction of both methods is significant in screening and diagnosing gastrointestinal hemorrhage and related diseases.