粪便隐血和轮状病毒检测的影响因素探讨

Influencing factors of fecal occult blood and rotavirus detection

目的探讨试剂和仪器自动化两方面因素对粪便隐血和轮状病毒检测结果的影响,为临床提供准确的结果和检测结果出现不一致时提供解释依据。方法分别收集门诊与病房患者大便标本,采用3个不同厂家胶体金法隐血试剂和轮状病毒试剂分别进行手工检测;仪器自动化检测采用湖南长沙协大生物粪便分析仪仪(XD-F6001B)及配套的单克隆血红蛋白试纸和轮状病毒试纸,待标本静置后吸取上清液进行手工加样检测,采用SPSS17.0统计软件进行数据分析,组间比较采用χ2检验及一致性分析,以P<0.05为差异有统计学意义。结果杭州安旭隐血试剂的灵敏度显著低于上海凯创与杭州艾博,差异均有统计学意义(P=0.02、0.00),但前二者检测结果一致性较好(κ=0.83)。杭州安旭轮状病毒试剂检测的灵敏度高于北京蓝十字,低于杭州艾博,差异均有统计学意义(P=0.01、0.00),但与北京蓝十字的一致性较好(κ=0.86),与杭州艾博的一致性较差(κ=0.37)。自动加样隐血阳性率明显低于静止后手工加样,过滤障碍造成的无效率明显高于手工加样,差异有统计学意义(P=0.00),二者检测结果一致性一般(κ=0.62)。自动加样轮状病毒阳性率明显低于静置后手工加样,过滤障碍造成的无效率明显高于手工加样,差异有统计学意义(P=0.00),但一致性较好(κ=0.78)。结论不同厂家隐血试剂和轮状病毒试剂检测的灵敏度与一致性存在不同,需合理选择以满足临床需要。仪器自动化隐血和轮状病毒检测因标本悬浮颗粒数量影响试剂膜层渗透致检测结果差异较大,仪器自动化仍需进一步优化。

Objective To explore the effects of instrument automation and different reagents on fecal occult blood and rotavirus results,to provide accurate clinical results and the interpretation basis for and inconsistency of test results. Methods Collecting fecal specimens from outpatient and ward,detecting the rotavirus and the occult blood used three kinds of reagents by mannual testing,and the hunan changsha xieda biological fecal analyzer(xd-f6001b) with the supporting diagnostic kit respectively.Using SPSS17.0 software for statistical processing.The comparison between groups with χ 2 test and the consistency analysis,and P <0.5 is taken as the significant difference. Results The sensitivity of hangzhou anxu reagent is significantly lower than that of Shanghai kaichuang( P =0.02) and hangzhou aibo( P =0.00).But the test results of the first two are good consistent(κ=0.83).The sensitivity of hangzhou anxu rotavirus reagent is higher than the Beijing blue cross( P =0.01) and lower than hangzhou aibo( P =0.00).However,it has good consistency with the Beijing blue cross(κ=0.86) and bad consistency with the hangzhou aibo(κ=0.37).The positive rate of automatic fecal occult blood test was significantly lower than that of manual test( P =0.00),and the consistency of the both tests is general(κ=0.62).The positive rate of automatic rotavirus test was significantly lower than that of manual test( P =0.00),but the inefficiencies caused by filtering obstacles are higher than that of manual test.Both of the consistency is good(κ=0.78). Conclusion The different reagents has different sensitivity and consistency,So reasonable selection is required to meet clinical needs.The results of instrument automation of occult blood and rotavirus detection vary greatly due to the influence of the number of suspended particles on the permeation of reagent film.The instrumentation automation still needs to be further optimized.