CAJ | 학술논문

目的探讨已建立的对颈动脉粥样硬化进行大规模流行病学调查的彩超诊断记分法的实用性及可重复性.方法通过现场流行病学调查得到99份颈动脉彩超片.3名经临床彩超医生培训的课题组成员,按照已经建立的标准(正常为0分,依病例严重程度分为1～7分),共同对99份彩超片进行诊断并记分1次;10日后3名课题组成员对99份彩超片各自独立进行盲评,诊断并记分.对诊断结果进行统计分析,检验该套诊断记分体系的可行性及可重复性.结果 3名课题组成员甲、乙、丙共同诊断的结果为0分27例、1分27例、12分10例、3分4例、4分13例、5分8例、6分6例、7分4例;甲独立诊断的结果为0分29例、1分24例、2分11例、3分2例、4分12例、5分11例、6分6例、7分4例;乙独立诊断的结果为0分29例、1分22例、2分14例、3分4例、4分13例、5分5例、6分8例、7分4例;丙独立诊断的结果为0分28例、1分25例、2分8例、3分5例、4分14例、5分10例、6分4例、7分5例.4次诊断的记分结果比较,差异无统计学意义(F=0.019,P＞0.05);甲、乙、丙分别诊断结果与共同诊断结果呈高度相关(r值分别为0.977、0.987和0.932,P均＜0.01),甲、乙、丙分别诊断结果之间亦呈高度相关(r值分别为0.969、0.935和0.928,P均＜0.01);甲、乙、丙分别诊断结果与共同诊断结果之间的符合率分别为88.9%(88/99)、90.9%(90/99)和86.9%(86/99).结论在流行病学调查研究中,颈动脉粥样硬化的彩超诊断记分法具有良好的实用性及可重复性.
목적 탐토이건립적대경동맥죽양경화진행대규모류행병학조사적채초진단기분법적실용성급가중복성.방법통과현장류행병학조사득도99빈경동맥채초편.3명경림상채초의생배훈적과제조성원,안조이경건립적표준(정상위0분,의병례엄중정도분위1～7분),공동대99빈채초편진행진단병기분1차;10일후3명과제조성원대99빈채초편각자독립진행맹평,진단병기분.대진단결과진행통계분석,검험해투진단기분체계적가행성급가중복성.결과 3명과제조성원갑、을、병공동진단적결과위0분27례、1분27례、12분10례、3분4례、4분13례、5분8례、6분6례、7분4례;갑독립진단적결과위0분29례、1분24례、2분11례、3분2례、4분12례、5분11례、6분6례、7분4례;을독립진단적결과위0분29례、1분22례、2분14례、3분4례、4분13례、5분5례、6분8례、7분4례;병독립진단적결과위0분28례、1분25례、2분8례、3분5례、4분14례、5분10례、6분4례、7분5례.4차진단적기분결과비교,차이무통계학의의(F=0.019,P＞0.05);갑、을、병분별진단결과여공동진단결과정고도상관(r치분별위0.977、0.987화0.932,P균＜0.01),갑、을、병분별진단결과지간역정고도상관(r치분별위0.969、0.935화0.928,P균＜0.01);갑、을、병분별진단결과여공동진단결과지간적부합솔분별위88.9%(88/99)、90.9%(90/99)화86.9%(86/99).결론재류행병학조사연구중,경동맥죽양경화적채초진단기분법구유량호적실용성급가중복성.
Objective To study the practicality and repeatability of B-mode ultrasonography on diagnosis and score of carotid atherosclerosis. Methods Ninety-nine B-mode ultrasonography pictures of carotid atherosclerosis were obtained from field investigation. According to the established standard(normal scored as 0, other scored as 1 - 7 by the severity), the 99 pictures were diagnosed and scored once together by three trained inexperienced members of the research team. Ten days later, these pictures were diagnosed and scored respectively, by the three members.The diagnostic results were analyzed with statistical methods to test the feasibility and repeatability of this set of diagnostic and scoring system. Results The joint diagnostic results by the three group members were regard as standard with scores 0 in 27 cases, 1 in 27 cases, 2 in 10 cases, 3 in 4 cases, 4 in 13 cases, 5 in 8 cases, 6 in 6 cases, and 7 in 4 cases. Independent diagnostic results by member A was 0 in 29 cases, 1 in 24 cases, 2 in 11 cases, 3 in 2 cases, 4 in 12 cases, 5 in 11 cases, 6 in 6 cases, and 7 in 4 cases. Independent diagnostic results by member B was 0 in 29 cases, 1 in 22 cases, 2 in 14 cases, 3 in 4 cases, 4 in 13 cases, 5 in 5 cases, 6 in 8 cases, and 7 in 4 cases. Independent diagnostic results by member C was 0 in 28 cases, 1 in 25 cases, 2 in 8 cases, 3 in 5 cases, 4 in 14 cases, 5 in 10 cases, 6 in 4 cases, and 7 in 5 cases. Comparison of the 4 diagnostic scores, the difference was not statistically significant(F = 0.019, P ＞ 0.05). Joint diagnostic results of the three members were compared with the standard and correlation coefficient were 0.977,0.987,0.932, respectively(all P ＜ 0.01 ). The correlation coefficient of diagnostic results of each member were 0.969,0.935,0.928, respectively (all P ＜0.01 ). Diagnostic results of each member were consistent with the standard and the compliance rate were 88.9% (88/99) ,90.9%(90/99) and 86.9%(86/99), respectively. Conclusions B-mode ultrasonography is a non-injure method for diagnosis of carotid atherosclerosis in epidemiology investigation. The method is easy to grasp and has a good repeatability.