Logistic回归联合ROC曲线评价超声对食管静脉曲张出血的预测价值  

Predictive Value of Ultrasonography for Esophageal Variceal Bleeding：Evaluated by ROC Curve Combined with Logistic Regression

作　　者：高风至[1] 褚瑞海[2] 贾德兴[2] 韩鹏[1] 张彩彩[1] 郭娜[1] 

机构地区：[1]潍坊医学院内科学教研室,山东潍坊261053 [2]潍坊医学院附属潍坊市人民医院传染科

出　　处：《潍坊医学院学报》2010年第5期351-353,共3页Acta Academiae Medicinae Weifang

摘　　要：目的应用Logistic回归模型及受试者特征工作曲线（ROC曲线）探讨超声指标对食管静脉曲张出血（EVB）的预测价值。方法对65例乙肝后肝硬化患者进行超声检测，出血组31例，非出血组34例，通过Logistic逐步回归分析，建立回归模型，并应用ROC曲线评价回归方程的诊断效能和最佳诊断界值。结果门静脉内径（DPV）、脾静脉内径（DSV）、脾脏长径（SL）是出血的危险因素，三者联合预测出血的ROC曲线下面积（AUC）高于单一指标的AUC（P〈0．05），预测EVB的诊断界值为0．40，其相应敏感性93．5％，特异性91．2％，正确性92．3％．结论DPV，DSV，SL构成的Logistic回归模型预测食管静脉曲张出血是可行的。Objective To explore the predictive value of ultrasonography for esophageal variceal bleeding（ EVB） , which was evaluated by receiver operating characteristic （ ROC） curve and a model of Logistic regression. Methods Ultrasonography was performed in 65 patients with post-hepatitis B cirrhosis. By analyzing with Logistic stepwise regression, a mathematical model was established. Then the diagnostic efficacy of the model was assessed and the diagnostic cut-off point for EVB was calculated using the ROC curve. Results The diameter of port＇al vein（ DPV） , spleen vein（DSV） and the splenic length（SL） were positively correlated with the risk of bleeding. The area under ROC curve（ AUC） of the three parameters was greater than that of either parameter alone（ P 〈 0.05 ）. The cut-off point,sensitivity,specificity and accuracy of the combined parameters for predicting EVB were 0.40,93.5% ,91.2% and 92.3% respectively. Conclusion A Logistic regression model consisting of DPV,DSV and SL is feasible in predicting the risk of esophageal varices bleeding.

关 键 词：LOGISTIC回归 ROC曲线 肝硬化 静脉曲张 超声 

分 类 号：R575.2[医药卫生—消化系统]