基于血小板相关参数及炎症指标的logistic回归模型对肠结核与克罗恩病的鉴别诊断价值  

Value of Logistic Regression Model Based on Platelet-related Parameters and Inflammatory Indexes in Differential Diagnosis of ITB and CD

作　　者：魏凯艳 刘益娟 王承党[1] WEI Kaiyan;LIU Yijuan;WANG Chengdang(Department of Gastroenterology,The First Affiliated Hospital of Fujian Medical University,The First Clinical Medical College of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院消化内科,第一临床医学院,福州350005

出　　处：《福建医科大学学报》2022年第5期392-396,共5页Journal of Fujian Medical University

基　　金：福建省科技创新联合基金(2019Y9120)。

摘　　要：目的研究基于血小板相关参数及炎症指标的logistic回归模型对肠结核(ITB)与克罗恩病(CD)的鉴别诊断价值。方法选择2013年1月—2019年12月笔者医院诊断的55例ITB和55例CD患者,比较2组患者的血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、血小板比积(PCT)、C-反应蛋白(CRP)、红细胞沉降率(ESR)的分布差别。利用ROC曲线评价PLT、PDW、PCT、CRP和ESR鉴别ITB和CD的灵敏度和特异度,根据最佳截断值将此5个连续性变量转变为二分类变量后纳入单因素及多因素二元logistic回归分析,建立logistic回归模型并探讨该模型对ITB与CD的鉴别诊断价值。结果2组患者的PLT、PDW、PCT、CRP、ESR比较,差别有统计学意义(P<0.05)。单因素及多因素二元logistic回归分析结果显示,PLT、PCT和ESR对ITB与CD具有鉴别诊断意义。[JP2]利用这3个指标建立临床鉴别模型logistic回归方程:logit(P)=1.238-1.199×PLT+0.879×PDW-1.579×ESR。logistic回归模型ROC曲线下面积为0.806(95%CI:0.723~0.889,P<0.001),当取最佳截断值0.463时,敏感度为74.5%,特异度为78.2%。结论基于血小板相关参数及炎症指标的logistic回归模型在CD与ITB的鉴别诊断中具有一定的临床意义。Objective To study value of logistic regression model based on platelet-related parameters and inflammatory indexes in differential diagnosis of intestinal tuberculosis(ITB)and Crohn's disease(CD).Methods 55 patients with ITB and 55 patients with CD from January 2013 to December 2019 were enrolled.ROC curves were used to evaluate the sensitivity and specificity of platelet count(PLT),platelet distribution width(PDW),plateletocrit(PCT),C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)in differentiating ITB from CD which were transformed into binary variables according to the optimal cutoff.Univariate and multivariate binary logistic regression were performed and logistic regression model was established to evaluete the model in the differential diagnosis of ITB and CD.Results There were statistically significant differences in PLT,PDW,PCT,CRP and ESR between 2 groups(P<0.05).The results of ultivariate and multivariate binary logistic regression showed that PLT,PDW and ESR were of diagnostic significance in differential diagnosis of ITB and CD.The regression equation of the diagnostic model based on these indicators for differential diagnosis of ITB and CD was as follows:logit(P)=1.238-1.199×PLT+0.879×PDW-1.579×ESR.The area under the ROC curve(AUC)was 0.806(95%CI:0.723-0.889).When the cut-off value of the diagnostic model was set as 0.463,the sensitivity was 74.5%and the specificity was 78.2%.Conclusions The logistic regression model based on platelet-related parameters and inflammatory indexes has certain clinical significance in differential diagnosis of ITB and CD.

关 键 词：克罗恩病 肠结核 血小板相关参数 炎症指标 LOGISTIC回归模型 

分 类 号：R574[医药卫生—消化系统] R524[医药卫生—内科学]