高级检索
石福艳, 杨丽平, 徐勇勇. 胆囊息肉样病变简易筛检工具研究[J]. 中国公共卫生, 2015, 31(5): 562-566. DOI: 10.11847/zgggws2015-31-05-06
引用本文: 石福艳, 杨丽平, 徐勇勇. 胆囊息肉样病变简易筛检工具研究[J]. 中国公共卫生, 2015, 31(5): 562-566. DOI: 10.11847/zgggws2015-31-05-06
SHI Fu-yan, YANG Li-ping, XU Yong-yong. Construction of simple index instrument for screening of gallbladder polypoid lesions[J]. Chinese Journal of Public Health, 2015, 31(5): 562-566. DOI: 10.11847/zgggws2015-31-05-06
Citation: SHI Fu-yan, YANG Li-ping, XU Yong-yong. Construction of simple index instrument for screening of gallbladder polypoid lesions[J]. Chinese Journal of Public Health, 2015, 31(5): 562-566. DOI: 10.11847/zgggws2015-31-05-06

胆囊息肉样病变简易筛检工具研究

Construction of simple index instrument for screening of gallbladder polypoid lesions

  • 摘要: 目的本研究拟设计一个能够有效筛检胆囊息肉病变(PLG)的简单工具, 为PLG的有效管理及防治提供参考。方法采用横断面病例-对照研究设计方法, 整群抽取2014年1月—8月在陕西省西安市第四军医大学第一附属医院西京医院体检中心进行健康体检且其体检信息满足本次研究要求的12 888名体检者进行问卷调查、体格检查、腹部超声检查和实验室检测。结果12 888名体检人群中, 219例被超声诊断患有PLG, 患病率为1.70%;多因素条件logistic回归分析结果表明, 在校正了变量间的交互作用及多重共线性后, 年龄较大、甘油三酯(TG)较高和间接胆红素较高是PLG的危险因素;将这些变量纳入构建PLG的预测模型中, 最终构建的预测指数为:PLG指数=13×年龄(年龄≥50,取值为1;年龄<50,取值为0)+间接胆红素+TG;PLG指数在训练数据集中的受试者工作特征曲线(ROC曲线)下面积为0.622(95%CI=0.571~0.673), 在验证数据集中的ROC曲线下面积为0.615(95%CI=0.562~0.660);PLG指数<P25P25~P75、>P75的PLG的阳性率分别为1.0%、1.7%、2.0%, 随着PLG指数的增加, PLG的阳性率随之增加(P<0.001)。结论PLG指数在增加筛检成本效益方面具有重要意义, 也可为PLG的有效防治和进一步的生活方式治疗提供帮助。

     

    Abstract: ObjectiveTo construct a simple index instrument applicable in the screening of polypoid lesions of gallbladder(PLG) for effective treatment of PLG.MethodsA cross-sectional case-control study was conducted among 12 888 physical examinees with questionnaire survey,physical examination,abdominal ultrasound detection,and laboratory test from January through August 2014 in Xijing Hospital Affiliated to Fourth Military Medical University.ResultsOf all the participants,219 were diagnosed with PLG and the prevalence rate was 1.7%.Multivariate logistic regression analysis showed that older age,high triglyceride(TG) and high indirect bilirubin were independent risk factors for PLG; then a PLG prediction model was constructed with the three indicators:PLG index=13×age(age=1 for over 50 and age=0 for younger than 50 years)+TG+indirect bilirubin.The PLG index had an area under the receiver-operating characteristic(AUROC) curve of 0.622(95% confidence interval95%CI:0.571-0.673)in the training set and 0.615(95%CI:0.562-0.660) in the validation set.The PLG positive rate was 1.0%,1.7%,and 2.0% for the participants with the PLG index value of less than percentage of 25(P25),between P25-P75,and greater than P75,respectively.With the increment of PLG index,the positive rate of gallbladder polypoid lesions gradually increased(P<0.001).ConclusionPLG index may be significant in promoting cost-effectiveness of PLG screening and could be used to select participants for studies on effective PLG diagnosis and treatment and/or lifestyle intervention.

     

/

返回文章
返回