我国干眼问卷的研制及评估  

Development and assessment of a dry eye questionnaire applicable to the Chinese population

作　　者：赵慧[1] 刘祖国[1] 杨文照[1] 肖辛野[1] 陈景尧[1] 李奇渊[1] 钟桃玲 

机构地区：[1]厦门大学眼科研究所及附属厦门眼科中心、福建省眼科与视觉科学重点实验室,361005

出　　处：《中华眼科杂志》2015年第9期647-654,共8页Chinese Journal of Ophthalmology

基　　金：卫生部公益行业基金（201302015）

摘　　要：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.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 di

关 键 词：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 

分 类 号：R777.34[医药卫生—眼科]