儿童晚发性佝偻病积分诊断评价  

Evaluating the Integration Diagnosis in Delayed Rickets in Children

作　　者：章殷捷[1] 柳会琼 谢玉程 叶文宣 叶怀庄[2] 刘日敏 

机构地区：[1]浙江省苍南县人民医院,325800 [2]浙江大学医学院公共卫生系

出　　处：《中国全科医学》2004年第14期1052-1054,共3页Chinese General Practice

基　　金：浙江省温州市社会发展科技计划资助课题(Y2 0 0 3A0 72 )

摘　　要：目的　确定晚发性佝偻病 (DR)诊断的金标准 ,并对简易积分诊断进行评价。方法　 346名DR可疑儿童中 ,按其病理生理指标确诊DR ,并以此为金标准 ,对骨碱性磷酸酶 (BALP)检查结果和DR积分情况用临床流行病学方法进行评价。结果　DR在可疑人群中检出率为 4 3 6 % ,血BALP >30 0IU/L时DR诊断特异性和阳性预测值均为 10 0 0 % ,2 0 0IU/L时阴性预测值为 95 6 % ;DR积分 2分时阴性预测值为 96 6 % ,4分时正确指数和Kappa值最高 ,分别为 70 7%和 0 6 3。DR积分≥ 4分时 ,积分越高、阳性预测值越高。结论　DR积分诊断是筛查DR可疑儿童较为理想、准确的可行手段。Objective To confirm the gold standard in diagnosis of Delayed Rickets(DR) and evaluate simply integration diagnosis.Methods Among 346 DR suspicious children, a definite diagnosis of DR was made according to its pathophysiologic index and was taken as the gold standard, the results of bone alkaline phosphatese (BALP) inspection and DR integration was evaluated with the clinic method of epidemiology.Results Among the suspicious people, 43.6% was detected. When blood BALP was equal to or greater than 300IU/L, DR diagnose had 100% specificity, 100% positive predicted values; when blood BALP was 200IU/L,it had 95.6% negative predicted value; As DR integration was 2, the negative predicted values was 96.6%,and as it was equal to or greater than 4,the correct index and the Kappa value which were maximal were 70.7% and 0.63 respectively.Conclusion DR integration diagnosis offers comparatively ideal, accurate feasible means to sift DR suspicious children.

关 键 词：儿童 晚发性佝偻病 积分 诊断 骨碱性磷酸酶 

分 类 号：R725.914.4[医药卫生—儿科]