Dybdahl J H, Daae L N, Larsen S
Scand J Gastroenterol. 1981;16(2):245-52. doi: 10.3109/00365528109181963.
Stools from volunteers participating in an acetylsalicylic acid (ASA) study were examined during periods with restrictive and liberal diets. With 51Cr-determined faecal blood less than 2 ml/100 g, the rates of positive benzidine and 3,3' ,5,5'-tetramethylbenzidine (TMB) tests were about 5% and 25% for periods with restrictive and liberal diets, respectively. Similarly, Fecatest showed 2% positive tests on a restrictive and 8% on a liberal diet, whereas Hemoccult II slide and BM-test-Hemafecia showed less than 5% positive tests on both diets. When ASA-induced blood loss (mainly gastric) exceeded 5 ml/100 g faeces, the rate of positive benzidine and TMB tests, including the Hemo-Fec Test, varied from 87% to 100%. Fecatest detected half of these cases, whereas Hemoccult II and BM-test-Hemafecia were positive in less than one third. By repeated analyses of faecal specimens stored for 3 days, Fecatest showed a substantially increased sensitivity. We assume that benzidine and TMB tests are sensitive enough to detect occult blood loss from all levels of the gastrointestinal tract, but dietary restrictions are essential to reduce the rate of false-positive tests. Guaiac tests, perhaps with the exception of Fecatest, should be reserved for the detection of occult blood loss from the lower gastrointestinal tract.
在严格饮食期和宽松饮食期对参与乙酰水杨酸（ASA）研究的志愿者的粪便进行了检查。当用51Cr测定的粪便出血量小于2 ml/100 g时，严格饮食期和宽松饮食期联苯胺和3,3',5,5'-四甲基联苯胺（TMB）试验的阳性率分别约为5%和25%。同样，Fecatest在严格饮食期的阳性检测率为2%，在宽松饮食期为8%，而隐血检测II玻片法和BM-粪便潜血检测法在两种饮食情况下的阳性检测率均低于5%。当ASA引起的失血量（主要为胃出血）超过5 ml/100 g粪便时，联苯胺和TMB试验（包括血液粪便检测）的阳性率在87%至100%之间。Fecatest检测出了其中一半的病例，而隐血检测II和BM-粪便潜血检测法的阳性率不到三分之一。通过对储存3天的粪便标本进行重复分析，Fecatest的灵敏度大幅提高。我们认为联苯胺和TMB试验灵敏度足以检测胃肠道各部位的潜血，但饮食限制对于降低假阳性率至关重要。除Fecatest外，愈创木脂试验应仅用于检测下消化道的潜血。
