CAJ | 학술논문

目的以简易智能量表(MMSE)为金标准,确定国际HIV相关性痴呆量表(IHDS)在广西少数民族地区不同文化程度人群中的诊断界值,并评价IHDS在相应界值下的真实性和可靠性.方法从广西少数民族地区筛选出血清阳性的HIV感染者200例,对每名感染者采用随机、同期、盲法测试MMSE和IHDS;以MMSE测试结果为金标准,通过ROC曲线确定IHDS在少数民族地区不同文化程度人群中的HIV相关性痴呆诊断界值,并评价特定界值下IHDS的灵敏度、特异度及内部一致性系数.结果当不考虑感染者的文化程度差异时,少数民族地区人群的IHDS诊断界值为8.25,此时IHDS的灵敏度为0.925、特异度为0.731、Kappa为0.477 (P＜ 0.001).当考虑感染者的文化程度差异时,不同文化程度人群的IHDS诊断界值有所不同:中学或以上文化人群的IHDS诊断界值为8.25,此时灵敏度为0.917、特异度为0.895、Kappa为0.722(P＜0.001)；小学文化人群的IHDS诊断界值为7.25,灵敏度为0.875、特异度为0.661、Kappa为0.372 (P＜0.001).结论广西少数民族地区人群的IHDS诊断界值低于国际推荐的诊断界值水平(IHDS≤10分)；在该地区运用IHDS筛查HIV相关性痴呆时,应根据当地HIV感染者的文化程度差异制订出适用于不同文化层次HIV感染者的IHDS诊断界值.
목적 이간역지능량표(MMSE)위금표준,학정국제HIV상관성치태량표(IHDS)재엄서소수민족지구불동문화정도인군중적진단계치,병평개IHDS재상응계치하적진실성화가고성.방법 종엄서소수민족지구사선출혈청양성적HIV감염자200례,대매명감염자채용수궤、동기、맹법측시MMSE화IHDS;이MMSE측시결과위금표준,통과ROC곡선학정IHDS재소수민족지구불동문화정도인군중적HIV상관성치태진단계치,병평개특정계치하IHDS적령민도、특이도급내부일치성계수.결과 당불고필감염자적문화정도차이시,소수민족지구인군적IHDS진단계치위8.25,차시IHDS적령민도위0.925、특이도위0.731、Kappa위0.477 (P＜ 0.001).당고필감염자적문화정도차이시,불동문화정도인군적IHDS진단계치유소불동:중학혹이상문화인군적IHDS진단계치위8.25,차시령민도위0.917、특이도위0.895、Kappa위0.722(P＜0.001)；소학문화인군적IHDS진단계치위7.25,령민도위0.875、특이도위0.661、Kappa위0.372 (P＜0.001).결론 엄서소수민족지구인군적IHDS진단계치저우국제추천적진단계치수평(IHDS≤10분)；재해지구운용IHDS사사HIV상관성치태시,응근거당지HIV감염자적문화정도차이제정출괄용우불동문화층차HIV감염자적IHDS진단계치.
Objective Using Intelligence Scale of Mini Mental State Estimated (MMSE) as the gold standard to determine the relevance of International HIV-associated Dementia Scale (IHDS)in minority ethnic areas in Guangxi populations with different cultural values.Corresponding boundary value related to the authenticity and reliability on IHDS were also evaluated.Methods 200 patients with HIV infection were randomly selected from the minority ethnic groups in Guangxi.For each infected person,MMSE and IHDS blind scale were tested at the same period.Using the results from MMSE scale test as the gold standard,ROC curve and IHDS scale in Guangxi minority populations with different education levels which related to the diagnosis of dementia-HIV values were determined.The value of a specific sector under the IHDS sensitivity,specificity,and internal consistency coefficients was also evaluated.Results When considering the infected person did not differ on their educational level,the IHDS scale diagnostic cutoff appeared as 8.25,while 1HDS sensitivity as 0.925,specificity as 0.731 and Kappa as 0.477 (P＜0.001).When considering the extent of cultural differences did influence the prevalence of infection,the different education groups showed different IHDS diagnostic cutoff values.People with high school,secondary school or higher education levels,the IHDS diagnosis appeared to be 8.25,when sensitivity was 0.917,specificity was 0.895 and Kappa was 0.722 (P＜0.001).People with only primary education level,the IHDS appeared to be 7.25.When sensitivity was 0.875,specificity was 0.661 and Kappa was 0.372 (P＜0.001).Conclusion The IHDS diagnostic sector in Guangxi minority groups was lower than the internationally recommended level of diagnostic cutoff value (IHDS≤ 10 points).When using IHDS to perform the HIV related dementia screening program,in the minority areas of Guangxi,culture context,the degree and difference of HIV infection should be considered,especially in using IHDS diagnostic cutoff values.