粪便隐血试验和转铁蛋白联合检测在诊断消化性出血中的意义

The significance of fecal occult blood test combined transferrin detection in the diagnosis of digestive hemorrhage

目的探讨粪便隐血试验联合转铁蛋白检测在消化性出血疾病中的诊断意义,为临床疾病诊治提供依据。方法选取2016年9月~2017年9月于我院就诊并经消化内镜及病理组织学确诊的消化性出血患者81例为观察组,按照出血位置不同分为上消化道出血组(51例)和下消化道出血组(30例),另选取同期于我院行健康体检的患者60例为对照组。以消化道内镜和病理组织学检测为金标准,判断粪便隐血试验和转铁蛋白检测的诊断意义。结果上消化道出血组粪便隐血实验检测阳性率(47.06%),转铁蛋白检测阳性率(50.98%),两者均显著低于联合检测阳性率(84.31%),差异有统计学意义(P<0.05)。下消化道出血组粪便隐血试验检测阳性率(56.67%),转铁蛋白检测阳性率(63.33%),两者均显著低于联合检测阳性率(86.67%),差异有统计学意义(P<0.05)。粪便隐血试验检测灵敏度(50.62%),转铁蛋白检测灵敏度(55.56%),两组均明显低于联合检测灵敏度(85.19%),差异有统计学意义(P<0.05)。三种检测方式特异度均为98.33%。结论粪便隐血实验联合转铁蛋白检测诊断消化道出血疾病有较高诊断准确率,高灵敏度及特异度,利于患者早期诊治,值得临床推广应用。

Objective To investigate the significance of fecal occult blood test combined transferrin detection in the diagnosis of digestive hemorrhage. Methods A total of 81 patients with digestive hemorrhage who were treated in our hospital from September 2016 to September 2017 were randomly selected as observation group. According to the location of the hemorrhage, they were divided into the upper gastrointestinal bleeding group（51 cases） and the lower gastrointestinal bleeding group（30 cases）, and 60 patients who had a health examination in our hospital during the same period were selected as the control group. The diagnostic significance of fecal occult blood test and transferritin detection was determined by endoscopy and histopathological examination. Results The positive rate of upper gastrointestinal bleeding was 47.06% with fecal occult blood test, and the positive rate of transferrotein detection was 50.98%, both of which were significantly lower than the joint test（84.31%）, with a statistical difference（P〈0.05）. The positive rate of fecal occult blood test in the lower gastrointestinal bleeding group was 56.67%. The positive rate of transferrotein detection was63.33%, both of which were significantly lower than the joint test（86.67%）, with a statistical difference（P〈0.05）. Fecal occult blood test alone the detection sensitivity was 50.62%, transferrin separate detection sensitivity was 55.56%, the two groups were significantly lower than 85.19% of joint detection, with a statistical difference（P〈0.05）. The specificity of the three methods were 98.33%. Conclusion The fecal occult blood test combined with transferrotein test for diagnosis and diagnosis of gastrointestinal hemorrhage has high diagnostic accuracy, high sensitivity and specificity, which is beneficial to the early diagnosis and treatment of patients, and it is worthy of clinical application.