临床三种常规粪便隐血实验的方法学评估

摘要

Objective To evaluate the performance of pyramidon chemical method, hemoglobin monoclonal antibody (monoclonal antibody) and transferring (Tf)/hemoglobin (Hb) combined immunoassay (combined immunoas-say). Methods Based on detection of 300 clinical specimens, Hb and vitamin C of different animals, the performanc-es of the three kinds of methods were assessed by indicators of sensitivity, interference experiment, and reaction time. Results The lowest detected concentration of Hb for pyramidon chemical method, monoclonal antibody and com-bined immunoassay was 2.5μg/ml, 0.1μg/ml, 0.1μg/ml, respectively. The lowest detected concentration of combined immunoassay for Tf was 0.05μg/ml. Monoclonal antibody and combined immunoassay only responsed to human he-moglobin, but pyramidon chemical method could react with hemoglobin and other common animals. Vit C did not af-fect monoclonal antibody and combined immunoassay, but it would make certain pyramidon assay to produce false negative results. The reaction time of the three methods were 17 s, 26 s, 24 s, respectively. The positive rate for the de-tection of upper gastrointestinal hemorrhage group, lower gastrointestinal hemorrhage group, the normal group were 95.1%, 73.7%, 10.8% by pyramidon chemical method, 74.4%, 94.7%, 2.5% by monoclonal antibody, and 90.2%, 100%, 6.7%by combined immunoassay. Conclusion Pyramidon assay, monoclonal antibody assay, combined immu-noassay has its own advantages for the detection of different parts of the digestive tract hemorrhage. Combined detec-tion of the three methods for auxiliary diagnosis of digestive tract diseases has important significance.%目的：对匹拉米洞法、血红蛋白单克隆抗体法(单克隆抗体法)和转铁蛋白(Tf)/血红蛋白(Hb)联合免疫法(联合免疫法)进行性能评估。方法通过300例临床样本和不同的动物血红蛋白(Hb)、维生素C(VitC)进行检测，从灵敏度、干扰性实验、反应时间等检测指标来反映三种方法的检验效能。结果匹拉米洞法、单克隆抗体法和联合免疫法检测Hb最低浓度分别为2.5µg/ml、0.1µg/ml、0.1µg/ml，联合免疫法检测Tf的最低浓度为0.05µg/ml。匹拉米洞法可以和人以及不同动物的血红蛋白反应，单克隆抗体法和联合免疫法只对人的血红蛋白反应；Vit C不会对单克隆抗体法和联合免疫法产生影响，一定的Vit C会使匹拉米洞法产生假阴性结果。三种方法的反应时间分别为17 s、26 s、24 s。匹拉米洞法检测上消化道隐血组、下消化道隐血组和对照组的阳性率分别为95.1%、73.7%、10.8%；单克隆抗体法分别为74.4%、94.7%、2.5%；联合免疫法分别为90.2%、100%、6.7%。结论匹拉米洞法、单克隆抗体法、联合免疫法对不同部位的消化道隐血的检测相辅相成，各具特点。三种方法联合检测对消化道疾病的辅助诊断具有重要的意义。