中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2009年
15期
1373-1375,1378
,共4页
吕曼%曹晓娜%刘娟%彭晓霞%闫宇翔%赵亚利%郭秀花%王慧丽%路孝琴%张津%张乐辉%崔树起
呂曼%曹曉娜%劉娟%彭曉霞%閆宇翔%趙亞利%郭秀花%王慧麗%路孝琴%張津%張樂輝%崔樹起
려만%조효나%류연%팽효하%염우상%조아리%곽수화%왕혜려%로효금%장진%장악휘%최수기
脑膜炎%诊断三联征%Logistic回归分析%诊断试验评价%数据库
腦膜炎%診斷三聯徵%Logistic迴歸分析%診斷試驗評價%數據庫
뇌막염%진단삼련정%Logistic회귀분석%진단시험평개%수거고
Meningitis%Diagnostic triad%Logistic regression analysis%Diagnostic value%Databases
目的 应用网络数据库进行数据挖掘,探讨建立用3～5个关键的症状、体征组合来初步快速判断脑膜炎的社区辅助诊断方法.方法 用中国知网数据库收集近4年符合纳入标准的161例脑膜炎患者和161例非脑膜炎患者完整的病例资料,以脑膜炎患者的临床症状、体征为自变量,采用单因素方法 进行变量筛选后对有统计学意义的变量进行多元Logistic回归分析,拟定脑膜炎诊断三联征,以病例诊断为金标准,对研究得出的诊断三联征的诊断效果进行评价.结果 应用多元回归方程提取出的脑膜炎初筛三联征是发热、头痛和脑膜刺激征,以其做工具检测脑膜炎的灵敏度是71.4%,特异度是78.9%,阳性预测值是77.2%,阴性预测值是73.4%;与金标准的诊断符合率用调整一致性指标来评价,为75.2%.结论 以发热、头痛和脑膜刺激征组合的脑膜炎诊断三联征作为一种简单、方便、快速和有效的方法,可用于基层医疗单位初筛脑膜炎患者,成为鉴别诊断和转诊患者的参考依据.
目的 應用網絡數據庫進行數據挖掘,探討建立用3～5箇關鍵的癥狀、體徵組閤來初步快速判斷腦膜炎的社區輔助診斷方法.方法 用中國知網數據庫收集近4年符閤納入標準的161例腦膜炎患者和161例非腦膜炎患者完整的病例資料,以腦膜炎患者的臨床癥狀、體徵為自變量,採用單因素方法 進行變量篩選後對有統計學意義的變量進行多元Logistic迴歸分析,擬定腦膜炎診斷三聯徵,以病例診斷為金標準,對研究得齣的診斷三聯徵的診斷效果進行評價.結果 應用多元迴歸方程提取齣的腦膜炎初篩三聯徵是髮熱、頭痛和腦膜刺激徵,以其做工具檢測腦膜炎的靈敏度是71.4%,特異度是78.9%,暘性預測值是77.2%,陰性預測值是73.4%;與金標準的診斷符閤率用調整一緻性指標來評價,為75.2%.結論 以髮熱、頭痛和腦膜刺激徵組閤的腦膜炎診斷三聯徵作為一種簡單、方便、快速和有效的方法,可用于基層醫療單位初篩腦膜炎患者,成為鑒彆診斷和轉診患者的參攷依據.
목적 응용망락수거고진행수거알굴,탐토건립용3～5개관건적증상、체정조합래초보쾌속판단뇌막염적사구보조진단방법.방법 용중국지망수거고수집근4년부합납입표준적161례뇌막염환자화161례비뇌막염환자완정적병례자료,이뇌막염환자적림상증상、체정위자변량,채용단인소방법 진행변량사선후대유통계학의의적변량진행다원Logistic회귀분석,의정뇌막염진단삼련정,이병례진단위금표준,대연구득출적진단삼련정적진단효과진행평개.결과 응용다원회귀방정제취출적뇌막염초사삼련정시발열、두통화뇌막자격정,이기주공구검측뇌막염적령민도시71.4%,특이도시78.9%,양성예측치시77.2%,음성예측치시73.4%;여금표준적진단부합솔용조정일치성지표래평개,위75.2%.결론 이발열、두통화뇌막자격정조합적뇌막염진단삼련정작위일충간단、방편、쾌속화유효적방법,가용우기층의료단위초사뇌막염환자,성위감별진단화전진환자적삼고의거.
Objective To try to set up an accessory diagnostic method in community,which depends upon a compound of 3-5 clinical symptoms and signs,for primarily quickly diagnosis of meningitis by using web-based data-mining techniques.Methods Totally 161 cases of meningitis and 161 cases of non-meningitis cases of patients with complete information from full-text databases of China National Knowledge Infrastructure(CNKI) were selected and reviewed.The clinical symptoms and signs of the patients were taken as independent variables,single-factor method was used to screen those variables with statistic significance,and then multiple Logistic regression analysis was applied to find out the related diagnostic triad.Finally clinical diagnosis was taken as the golden criteria to evaluate the diagnostic effects of the diagnostic triad gained from the study.Results The gained triad based on multiple regression equation for primarily screening meningitis were fever,headache and meningeal irritation sign.The sensitivity of the meningitis triad was 71.4%,specificity was 78.9%,positive predictive value was 77.2% and negative predictive value was 73.4%.The agreeable degree with gold criteria was 75.2% as assessed by adjusted agreement indices.Conclusion The triad consisting of fever,headache and meningeal irritation sign for miningitis diagnosis is a simple,convenient quick and effective method.It can be used for primarily screening of meningitis patients at basic medical care units,which becomes referent evidences for differentiation of diagnosis and referral of patients.
