中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
4期
402-404
,共3页
糖尿病%周围神经病变%筛查%评分量表
糖尿病%週圍神經病變%篩查%評分量錶
당뇨병%주위신경병변%사사%평분량표
Diabetes mellitus%Peripheral neuropathy%Screening%Scoring systems
目的 比较密歇根神经病变筛查评分系统(MNSI)、密歇根糖尿病神经病变评分(MDNS)、多伦多临床评分系统(TCSS)在糖尿病周围神经病变(DPN)筛查中的价值,寻求简单、快捷、准确的筛查手段.方法 选取我院327例2型糖尿病患者,对其分别行MNSI、MDNS、TCSS和神经电生理检查,以神经电生理检查为金标准,分析各量表的灵敏度、特异度、准确度、阳性预测值、阴性预测值、约登指数、K值及ROC曲线下面积,评价其诊断价值.结果 以神经电生理检查为标准,各量表的敏感度、特异度、准确度分别为MDNS 90.50％ (162/179)、68.92％(102/148)、80.73％ (264/327),MNSI 87.71％ (157/179)、78.38％ (116/148)、83.49％ (273/327),TCSS 79.33％(142/179)、65.54％ (97/148)、73.09％ (239/327).MNSI、MDNS与神经电生理检查之间呈高度一致(K值分别0.6 648、0.6 045),MNSI、TCSS一致性较差,呈中度一致(K值为0.4 524).MNSI、MDNS、TCSS诊断DPN的ROC曲线下面积分别为0.757、0.719、0.667,MNSI的真实性最佳.结论 MNSI可靠性强,且简单、快捷、可行性好,更适用于DPN的早期大规模筛查.
目的 比較密歇根神經病變篩查評分繫統(MNSI)、密歇根糖尿病神經病變評分(MDNS)、多倫多臨床評分繫統(TCSS)在糖尿病週圍神經病變(DPN)篩查中的價值,尋求簡單、快捷、準確的篩查手段.方法 選取我院327例2型糖尿病患者,對其分彆行MNSI、MDNS、TCSS和神經電生理檢查,以神經電生理檢查為金標準,分析各量錶的靈敏度、特異度、準確度、暘性預測值、陰性預測值、約登指數、K值及ROC麯線下麵積,評價其診斷價值.結果 以神經電生理檢查為標準,各量錶的敏感度、特異度、準確度分彆為MDNS 90.50％ (162/179)、68.92％(102/148)、80.73％ (264/327),MNSI 87.71％ (157/179)、78.38％ (116/148)、83.49％ (273/327),TCSS 79.33％(142/179)、65.54％ (97/148)、73.09％ (239/327).MNSI、MDNS與神經電生理檢查之間呈高度一緻(K值分彆0.6 648、0.6 045),MNSI、TCSS一緻性較差,呈中度一緻(K值為0.4 524).MNSI、MDNS、TCSS診斷DPN的ROC麯線下麵積分彆為0.757、0.719、0.667,MNSI的真實性最佳.結論 MNSI可靠性彊,且簡單、快捷、可行性好,更適用于DPN的早期大規模篩查.
목적 비교밀헐근신경병변사사평분계통(MNSI)、밀헐근당뇨병신경병변평분(MDNS)、다륜다림상평분계통(TCSS)재당뇨병주위신경병변(DPN)사사중적개치,심구간단、쾌첩、준학적사사수단.방법 선취아원327례2형당뇨병환자,대기분별행MNSI、MDNS、TCSS화신경전생리검사,이신경전생리검사위금표준,분석각량표적령민도、특이도、준학도、양성예측치、음성예측치、약등지수、K치급ROC곡선하면적,평개기진단개치.결과 이신경전생리검사위표준,각량표적민감도、특이도、준학도분별위MDNS 90.50％ (162/179)、68.92％(102/148)、80.73％ (264/327),MNSI 87.71％ (157/179)、78.38％ (116/148)、83.49％ (273/327),TCSS 79.33％(142/179)、65.54％ (97/148)、73.09％ (239/327).MNSI、MDNS여신경전생리검사지간정고도일치(K치분별0.6 648、0.6 045),MNSI、TCSS일치성교차,정중도일치(K치위0.4 524).MNSI、MDNS、TCSS진단DPN적ROC곡선하면적분별위0.757、0.719、0.667,MNSI적진실성최가.결론 MNSI가고성강,차간단、쾌첩、가행성호,경괄용우DPN적조기대규모사사.
Objective To evaluate the effectiveness of the Michigan neuropathy screening instrument (MNSI),the Michigan Diabetic Neuropathy Score(MDNS) and the Toronto Clinical Scoring System(TCSS) in screening diabetic peripheral neuropathy (DPN) in order to find a rapid,simple and accurate way for DPN screening.Methods Three hundred and twenty-seven type 2 diabetic patients were enrolled in the study.All patients received the 4 simple tests including MNSI,MDNS,TCSS and neural electrophysiological test (NET).Taking the results of NET as the golden criteria,the sensitivity,specificity,positive and negative predictive values,accuracy,Youden indexes and Kappa values of the scoring systems were analyzed to evaluate their clinical effectiveness.Results Compared with NET examination,sensitivity,specificity and accuracy of MDNS were 90.5％ (162/179),68.92％ (102/148),80.73％ (264/327),and 87.71％ (157/179),78.38％ (116/148),83.49％ (273/327) for MNSI and 79.33％ (142/179),65.54％ (97/148),73.09％ (239/327) for TCSS.MNSI and MDNS were better than TCSS in terms of effectiveness of DPN diagnosis and consistence with the result of NET (MDNS:0.6 045 ; MNSI:0.6 648 ; TCSS:0.4524).The area under the ROC curve of MNSI,MDNS and TCSS were 0.757,0.719,0.667.Conclusion Among the three scales methods,MNSI is a better method in screening DPN for its simplicity and reliability.
