中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2015年
9期
647-654
,共8页
赵慧%刘祖国%杨文照%肖辛野%陈景尧%李奇渊%钟桃玲
趙慧%劉祖國%楊文照%肖辛野%陳景堯%李奇淵%鐘桃玲
조혜%류조국%양문조%초신야%진경요%리기연%종도령
干眼综合征%眼痛%畏光%问卷调查%疾病严重程度指数%生活质量
榦眼綜閤徵%眼痛%畏光%問捲調查%疾病嚴重程度指數%生活質量
간안종합정%안통%외광%문권조사%질병엄중정도지수%생활질량
Dry eye syndromes%Eye pain%Photophobia%Questionnaires%Severity of illness index%Quality of life
目的 研制适用于我国人群的干眼问卷并评价其临床应用价值.方法 经查阅分析国内外干眼文献资料并结合临床实践,设计适合我国干眼人群的问卷,并进行语言表达和文化背景因素的调适优化.招募160名受试者(干眼组78例,对照组82例)对此干眼问卷和眼表疾病指数(OSDI)问卷进行作答,并进行泪膜破裂时间、角膜荧光素染色评分、泪液分泌试验、睑板腺评估等干眼相关临床检查.根据问卷调查结果和临床检查结果用因子分析方法对原问卷进行优化;用克朗巴赫系数α和组内相关系数分别评价所设计干眼问卷和OSDI问卷的内部一致性信度和重测信度;通过因子分析评价结构效度;Spearman相关分析评价关联效度;方差分析和秩和检验分析判别效度;通过计算受试者工作特征曲线下面积(AUC)比较两种问卷对干眼诊断的准确度.结果 通过因子分析将初始问卷优化为12道题的干眼问卷,干眼问卷应答率为100％,OSDI问卷应答率为91.25％;干眼问卷和OSDI问卷的克朗巴赫α系数分别为0.794和0.925,内部一致性好;两份问卷组内相关系数均为0.99,表明重测信度良好;因子分析表明两份问卷结构效度良好;两份问卷评分结果高度正相关(r=0.812,P＜0.01),两份问卷分别与干眼各临床检查指标有相关性,且干眼问卷与体征总分相关性较OSDI问卷更高(r=0.613,0.605;P＜0.01);干眼问卷评分对干眼组与对照组的判别效度良好(P＜0.01);当干眼问卷评分诊断阈值为7时,对应的敏感度和特异度分别为83.33％与70.73％,其AUC值为0.814,大于OSDI问卷的0.772(P＜0.01).结论 研制的干眼问卷更符合我国人群的使用习惯,信度、效度及特异度、敏感度均较高,在国人干眼临床诊断中较OSDI问卷显示出更好的诊断价值.
目的 研製適用于我國人群的榦眼問捲併評價其臨床應用價值.方法 經查閱分析國內外榦眼文獻資料併結閤臨床實踐,設計適閤我國榦眼人群的問捲,併進行語言錶達和文化揹景因素的調適優化.招募160名受試者(榦眼組78例,對照組82例)對此榦眼問捲和眼錶疾病指數(OSDI)問捲進行作答,併進行淚膜破裂時間、角膜熒光素染色評分、淚液分泌試驗、瞼闆腺評估等榦眼相關臨床檢查.根據問捲調查結果和臨床檢查結果用因子分析方法對原問捲進行優化;用剋朗巴赫繫數α和組內相關繫數分彆評價所設計榦眼問捲和OSDI問捲的內部一緻性信度和重測信度;通過因子分析評價結構效度;Spearman相關分析評價關聯效度;方差分析和秩和檢驗分析判彆效度;通過計算受試者工作特徵麯線下麵積(AUC)比較兩種問捲對榦眼診斷的準確度.結果 通過因子分析將初始問捲優化為12道題的榦眼問捲,榦眼問捲應答率為100％,OSDI問捲應答率為91.25％;榦眼問捲和OSDI問捲的剋朗巴赫α繫數分彆為0.794和0.925,內部一緻性好;兩份問捲組內相關繫數均為0.99,錶明重測信度良好;因子分析錶明兩份問捲結構效度良好;兩份問捲評分結果高度正相關(r=0.812,P＜0.01),兩份問捲分彆與榦眼各臨床檢查指標有相關性,且榦眼問捲與體徵總分相關性較OSDI問捲更高(r=0.613,0.605;P＜0.01);榦眼問捲評分對榦眼組與對照組的判彆效度良好(P＜0.01);噹榦眼問捲評分診斷閾值為7時,對應的敏感度和特異度分彆為83.33％與70.73％,其AUC值為0.814,大于OSDI問捲的0.772(P＜0.01).結論 研製的榦眼問捲更符閤我國人群的使用習慣,信度、效度及特異度、敏感度均較高,在國人榦眼臨床診斷中較OSDI問捲顯示齣更好的診斷價值.
목적 연제괄용우아국인군적간안문권병평개기림상응용개치.방법 경사열분석국내외간안문헌자료병결합림상실천,설계괄합아국간안인군적문권,병진행어언표체화문화배경인소적조괄우화.초모160명수시자(간안조78례,대조조82례)대차간안문권화안표질병지수(OSDI)문권진행작답,병진행루막파렬시간、각막형광소염색평분、루액분비시험、검판선평고등간안상관림상검사.근거문권조사결과화림상검사결과용인자분석방법대원문권진행우화;용극랑파혁계수α화조내상관계수분별평개소설계간안문권화OSDI문권적내부일치성신도화중측신도;통과인자분석평개결구효도;Spearman상관분석평개관련효도;방차분석화질화검험분석판별효도;통과계산수시자공작특정곡선하면적(AUC)비교량충문권대간안진단적준학도.결과 통과인자분석장초시문권우화위12도제적간안문권,간안문권응답솔위100％,OSDI문권응답솔위91.25％;간안문권화OSDI문권적극랑파혁α계수분별위0.794화0.925,내부일치성호;량빈문권조내상관계수균위0.99,표명중측신도량호;인자분석표명량빈문권결구효도량호;량빈문권평분결과고도정상관(r=0.812,P＜0.01),량빈문권분별여간안각림상검사지표유상관성,차간안문권여체정총분상관성교OSDI문권경고(r=0.613,0.605;P＜0.01);간안문권평분대간안조여대조조적판별효도량호(P＜0.01);당간안문권평분진단역치위7시,대응적민감도화특이도분별위83.33％여70.73％,기AUC치위0.814,대우OSDI문권적0.772(P＜0.01).결론 연제적간안문권경부합아국인군적사용습관,신도、효도급특이도、민감도균교고,재국인간안림상진단중교OSDI문권현시출경호적진단개치.
Objective To develop and assess a new dry eye questionnaire applicable to the Chinese population.Methods Based on literature review and clinical practice,a dry eye questionnaire was developed and optimized to apply to Chinese dry eye patients in the language expression and culture background.Participants (78 patients with dry eye and 82 controls) completed the dry eye questionnaire and the ocular surface disease index (OSDI) questionnaire,and ophthalmic examinations were performed,including slit lamp examination,tear breakup time,fluorescein staining,Schirmer I test and meibomian gland assessment.The original questionnaire was optimized with factor analysis according to the answers from respondents and clinical evaluations.The Cronbach αand intraclass correlation coefficient (ICC) were used to evaluate the internal consistency reliability and test-retest reliability.Factor analysis was used to assess the construct validity,concurrent validity was obtained by Spearman correlation analysis,and discriminant validity was obtained by ANOVA and Wilcoxon rank sum test.Receiver operator characteristics curves were generated to identify the sensitivity and specificity of each questionnaire for diagnosis of dry eye.Results The questionnaire was optimized to 12 items by factor analysis.The response rate from respondents to the dry eye questionnaire and the OSDI was 100％ and 91.25％,respectively.The Cronbachαof the dry eye questionnaire and the OSDI was 0.794 and 0.925,respectively,whilst the ICC of both questionnaires was 0.99,indicating good to excellent rehability.The factor analysis suggested that these two questionnaires had good construct validity.The Spearman correlation analysis indicated that the dry eye questionnaire score correlated positively with the OSDI score(r=0.812,P＜0.01)and had a greater correlation relationship with the clinical evaluations compared with the OSDI score(r for each was 0.613 and 0.605,P＜0.01).The discriminant validity analysis suggested that there was significant difference in the dry eye questionnaire score between the dry eye group and non-dry eye group (P＜0.01).When the dry eye questionnaire score of 7 was used as the diagnostic threshold,the sensitivity and specificity were 83.33％ and 70.73％,respectively,and the area under roc curve was 0.814,which was higher than 0.772 of the OSDI (P＜0.01).Conclusion The dry eye questionnaire we developed is applicable to the Chinese population with Chinese culture characteristics,high reliability,validity,specificity,and sensitivity,and holds a better diagnostic value than the OSDI for Chinese patients with dry eye.
