Effect of in vitro gastrointestinal environment on immunochemical fecal occult blood test
Effect of in vitro gastrointestinal environment on immunochemical fecal occult blood test
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DOI：
10.3760/cma.j.issn.1009-9158.2017.04.016
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发表时间：
2017-04
影响因子：
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通讯作者：
Ping Wang;Hui Liu;Tie Zhang
中科院分区：
文献类型：
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作者：
Ping Wang;Hui Liu;Tie Zhang
目的探讨胃肠道环境对粪便潜血试验的影响。方法收集2015年中日友谊医院体检中心25名健康志愿者的混合外周静脉血（45 ml），建立体外胃肠道消化模型。利用该模型研究了不同消化时间和消化液浓度对两种潜血检测试剂免疫化学法粪便潜血试验的影响。结果出血量> 5 ml时，人工胃液消化2 h、人工肠液消化5 h后，便潜血试验仍为阳性，人工胃液消化0.5 ~ 3 h、人工肠液消化3 h后便潜血试验转为阴性。大便潜血试验阳性率与出血量密切相关。当出血量大、出血急时，后带现象可引起假阴性。两种试剂的检测上限均大于3165 ng/L，检测下限均为0.2ng/L。结论免疫法不仅对下消化道出血阳性率高，对上消化道出血也有较高的阳性率。免疫化学法粪便潜血试剂检测范围广，能满足临床上检测消化道出血的要求。(Chin J Lab Med，2017，40：294-297）关键词：潜血;粪便;胃肠道;血红蛋白
Objective To investigate the effect of gastrointestinal environment on fecal occult blood test. Methods Mixed peripheral venous blood (45 ml) of 25 healthy volunteers from medical examination center of China-Japan Friendship Hospital in 2015 were collected to establish an in vitro gastrointestinal digestion model. The model was used to study the effects of different digestion time and concentration of digestive juice on the immunochemical fecal occult blood test using two kinds of occult blood detection reagents. Results When the amount of bleeding was over 5 ml, fecal occult blood test still showed positive after artificial stomach liquid digestion for 2 hours and artificial intestinal liquid digestion for 5 hours.The fecal occult blood test turned negative after artificial stomach liquid digestion for 0.5-3 hours and artificial intestinal liquid digestion for 3 hours. The positive rate of fecal occult blood test was closely related to the amount of bleeding. When the amount of bleeding was large and bleeding was acute, false negative could be caused by postzone phenomenon. The upper detection limit of two reagents was more than 3 165 ng/L, and the lower detection limit was0.2 ng/L. Conclusions Higher positive rate was detected not only in lower digestive tract bleeding but also in upper gastrointestinal bleeding with immunoassay method. Immunochemical fecal occult blood reagent had a wide detection range and could meet the clinical requirements for detection of gastrointestinal bleeding. (Chin J Lab Med, 2017, 40: 294-297) Key words: Occult blood; Feces; Gastrointestinal tract; Hemoglobins