基于ROC分析的非创伤性股骨头坏死塌陷预测方法  

Collapse prediction for patients with femoral head necrosis via ROC analysis

作　　者：孔祥泉[1] 黄梅军 黎全猛[1] 梁志建[1] 唐扬伟 

机构地区：[1]怀集县人民医院骨科,广东怀集526400

出　　处：《岭南现代临床外科》2016年第3期317-320,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨股骨头坏死(FHN)区域夹角/面积的比值在预测非创伤性缺血性股骨头坏死患者出现股骨头塌陷的敏感度及特异度。方法收集31例37髋FHN患者进行长期随访,测量其坏死面积及夹角,使用受试者工作特征曲线(ROC)法评价以上患者出现股骨头塌陷的敏感度及特异度。结果 37髋共有11髋出现股骨头塌陷(29.7%);与未塌陷组(对照组)比较,塌陷组的坏死区域夹角及坏死面积均大于对照组(P=0.001、0.001),且夹角/面积比值同样明显大于对照组(P<0.001);夹角对应的曲线下面积(AUC)为0.772,95%可信区间(CI)为(0.613,0.932),面积对应的AUC为0.724,95%CI为(0.516,0.814),而夹角/面积对应的AUC为0.785,95%CI为(0.627,0.944)。夹角、面积及夹角/面积比值三者均与股骨头塌陷存在显著相关性(P值分别为0.008、0.019及0.005);当夹角/面积取值为1.895(108°/57%)时,该比值预测股骨头塌陷的敏感度为97.5%,特异度为98.4%,高于而夹角对应的96.3%及87.4且高于面积对应为的76.4%及92.5%。结论股骨头坏死区域夹角为108°或坏死面积为57%时,需高度警惕股骨头出现塌陷的可能;夹角/面积比值在预测股骨头塌陷的敏感度及特异度均优于夹角或面积单一指标。Objective Toinvestigate the angle of femoral head necrosis （FHN）/necrosisarea ratio in the prediction of patients with traumatic ischemic necrosis of femoral head in the sensitivity of the collapse of the femoral head and specific degrees. Methods Thirty-sevenhips of 31 patients with hip FHN were collected for long-term follow-up, measuring the necrosis area and angle （coronal plane of MRI）, using the receiver-operating characteristic curve （ROC） method to evaluate the sensitivity of the patients with femoral head collapse and specific degrees. Results Of 37 hips, a total of 11 hips showed collapse of the femoral head （29.7%）. Compared with control group （without collapse）, the necrosis angle and the necrosis area weresignificant increased （P=0.001 ,P=0.001 ）, and the angle/ area ratio was also significantly greater than that of control group （P〈0.001）. The area under the curve （AUC） of necrosis angle was 0.772, with 95% confidence interval （CI） was（0.613, 0.932）. The area of the corresponding AUC was 0.724, 95% CI （0.516, 0.516）, and the corresponding AUC/Angle area was 0.785, 95% CI （0.627, 0.627）.Angle, area and Angle/area ratio and femoral head collapse existed significant correlation （P=0.008, 0.019, 0.005, respectively）. When the angle/ area value was 1.895 （ 108°/57%）, the ratio to predict the sensitivity of the collapse of the femoral head were 97.5% and 98.4%, higher than the corresponding angle of 96.3% and 87.4 and above the area corresponding to 76.4% and 92.5%. Conclusion In our study, the necrosis angle was 108° or femoral head necrosis area coverd an area of 57%, it should be highly on guard that femoral head occurred in collapse.Angle/area ratio in the prediction of the sensitivity of the collapse of the femoral head and or specific degrees were superior to angle area of single index.

关 键 词：股骨头坏死 夹角 面积 敏感度 特异度 

分 类 号：R683.42[医药卫生—骨科学]