Moran A, Husband D, Jones A F, Asquith P
Department of Gastroenterology, Birmingham Heartlands Hospital.
Gut. 1995 Jan;36(1):87-9. doi: 10.1136/gut.36.1.87.
This study evaluates the diagnostic accuracy of a faecal occult blood test and faecal alpha 1-antitrypsin in the investigation of patients with gastrointestinal symptoms or iron deficiency anaemia. One hundred and seventy nine patients with either iron deficiency anaemia (n = 67), changed bowel habit and aged > 39 years (n = 107), or a history suggestive of melaena (n = 5) provided faecal samples. After investigation, 32 patients had a diagnosis of possible gastrointestinal bleeding and 139 patients had no evidence of gastrointestinal bleeding. Eight patients had a cause of enteric protein loss in the absence of gastrointestinal bleeding and were excluded from subsequent analysis. The faecal alpha 1-antitrypsin test was diagnostically more accurate than the guaiac test in identifying probable gastrointestinal bleeding (82% and 72% respectively, p < 0.05). This faecal alpha 1-antitrypsin test was also more specific (83% and 72% respectively, p < 0.05), but was not significantly more sensitive (78% and 72% respectively). The sensitivity of these tests was insufficient to recommend their use for most patients in this study.
本研究评估了粪便潜血试验和粪便α1-抗胰蛋白酶在调查有胃肠道症状或缺铁性贫血患者中的诊断准确性。179例患者提供了粪便样本，这些患者包括缺铁性贫血患者（n = 67）、排便习惯改变且年龄大于39岁的患者（n = 107）或有黑便病史的患者（n = 5）。经检查，32例患者被诊断为可能有胃肠道出血，139例患者无胃肠道出血证据。8例患者在无胃肠道出血的情况下存在肠蛋白丢失原因，被排除在后续分析之外。在识别可能的胃肠道出血方面，粪便α1-抗胰蛋白酶试验在诊断上比愈创木脂试验更准确（分别为82%和72%，p < 0.05）。该粪便α1-抗胰蛋白酶试验也更具特异性（分别为83%和72%，p < 0.05），但在敏感性方面没有显著提高（分别为78%和72%）。在本研究中，这些试验的敏感性不足以推荐用于大多数患者。
