免疫法粪便隐血试验用于消化系统疾病的消化道出血评估研究

Clinical Value of Immune Fecal Occult Blood Test in Detecting Gastrointestinal Bleeding from Digestive Disease

目的探讨免疫法粪便隐血试验在消化系统疾病患者出血评估的临床价值。方法回顾性分析厦门大学附属中山医院2009年1月—2010年6月住院的消化系统疾病患者免疫法粪便隐血检测结果,比较不同年龄、性别、疾病部位和疾病种类的阳性率差异。结果 1 500例消化系统疾病患者粪便隐血试验阳性率为35.3%(529/1 500),其中男性阳性率为37.6%(376/999),女性为30.5%(153/501),二者差异无统计学意义(χ2=7.37,P=0.07);大于70岁患者阳性率高于70岁以下,不同年龄组患者阳性率间差异有统计学意义(χ2=13.89,P=0.03);胃、结肠与直肠肿瘤患者粪便隐血试验阳性率分别为53.0%(70/132)、61.3%(38/62)和71.1%(32/45),与同组内其他非肿瘤疾病患者比较差异有统计学意义(P<0.05);消化道外的胰腺和肝胆疾病患者粪便隐血试验阳性率达到20%左右。结论免疫法粪便隐血试验对于胃、结肠、直肠等消化道肿瘤具有一定的辅助诊断价值;对于评估胰腺、肝胆等消化道外疾病的消化道出血情况也有一定的临床应用价值。

Objective To evaluate the clinical value of fecal occult blood test in detecting gastrointestinal bleeding from digestive disease. Methods We retrospectively analyzed the fecal occult blood test results of the inpatients with digestive diseases in Xiamen University affiliated Zhongshan Hospital between January 2009 and June 2010. Positive rates were compared among the groups by age, gender, disease location and disease type. Results The positive rate of fecal occult blood test among the 1 500 inpatients with digestive diseases was 35.3%. No significant difference was observed between male （37.6%, 376/ 999） and female patients （30. 5%, 153/501 ） （X2 = 7. 37, P = 0. 07） . The positive rate was higher among those above 70 years old than those below （X2 = 13.89, P = 0. 03） . The positive rates among patients with gastric tumor, colon tumor and rectal tumor were 53.0% （70/132）, 61.3 % （38/62）, and 71.1% （32/45）, respectively, which were all significantly higher than those of the benign diseases of the same location （P 〈0. 05 ） . The positive rate was about 20% for diseases outside the di- gestive tract, including the pancreatic and hepatobiliary diseases. Conclusion The fecal occult blood test has significant value in assisting diagnosis of gastrointestinal cancer, and can also be used for the evaluation of gastrointestinal bleeding in pancreatic and hepatobiliary diseases.