三种方法检测173例先天性红绿色觉异常患者的诊断效能比较  

Comparison of diagnostic performance of three methods for congenital protan/deutan color vision deficiency in 173 cases

作　　者：王培红 俞俊 李朝辉 贾亮[2] WANG Peihong;YU Jun;LI Zhaohui;JIA Liang(Chinese PLA Medical School,Beijing 100853,China;Senior Department of Ophthalmology,the Third Medical Center,Chinese PLA General Hospital,Beijing 100039,China;Department of Ophthalmology,Yiwu Aier Eye Hospital,Yiwu 322000,Zhejiang Province,China)

机构地区：[1]解放军医学院,北京100853 [2]解放军总医院第三医学中心眼科医学部,北京100039 [3]义乌爱尔眼科医院眼科,浙江义乌322000

出　　处：《解放军医学院学报》2023年第7期774-779,786,共7页Academic Journal of Chinese PLA Medical School

摘　　要：背景先天性红绿色觉异常(color vision deficiency,CVD)的诊断存在分型不准,分度不明等问题。目的以Fornsworth Munsell-100 hue test(FM-100)色觉检测法为标准,评估《俞自萍色盲本》(俞本)、色盲检测(Color Blind Check,CBC)评分法对红绿CVD患者分型和严重度分度的判定能力。方法采用俞本、CBC评分和FM-100三种方法对2022年2-7月在解放军总医院眼科就诊的CVD患者进行检测,并以FM-100为标准,评价俞本和CBC评分的诊断效能和符合度。结果在纳入的173例患者中,检出红、绿色觉异常者比例,俞本为1.2%和12.7%,CBC评分为36.4%和62.4%,FM-100为19.1%和65.9%。严重度方面三种方法结果相似。以FM-100为金标准,俞本和CBC评分对先天性色觉异常分度诊断的敏感度和特异度分别为91.3%和38.5%、92.5%和46.2%,ROC曲线下面积分别为0.712和0.604。以FM-100为金标准,俞本和CBC评分对先天性色觉异常分型诊断:诊断红色觉异常的敏感度和特异度分别为0和15.8%、75.8%和78.9%,Kappa值分别为-0.125和0.490;诊断绿色觉异常的敏感度和特异度分别为15.8%和0、78.9%和75.8%,Kappa值分别为-0.125和0.490。平均检测时间:俞本<CBC评分<FM-100。结论俞本能够快速筛查CVD并初步判定严重度;CBC评分具有一定的分型和分度能力,结果稳定,耗时短,且无法作弊,具有一定的临床应用前景。Background The diagnosis of congenital protan/deutan color vision deficiency(CVD)is still problematic,with inaccurate classification and unclear severity.Objective To evaluate the ability of Yu's color blindness test(Yu’s)book and Color Blind Check(CBC)score for classification and severity division of patients with CVD compared to Fornsworth Munsell-100 hue test(FM-100),so as to improve the clinical diagnosis level and provide reference for its treatment.Methods Yu's book,CBC score and FM-100 were used to detect patients with CVD who were admitted to the Third Medical Center of Chinese PLA General Hospital from February to July in 2022.Compared with FM-100,the diagnostic efficacy and classification error rate of the CBC score and Yu's book were evaluated.Results Among the 173 patients,those with abnormal red and green perception were 1.2%and 12.7%by Yu's book,36.4%and 62.4%by CBC score,19.1%and 65.9%by FM 100.The results of the three methods of severity were similar.Taking FM-100 as the gold standard,the sensitivity and specificity of Yu's book and CBC score of CVD severity division were 91.3%and 38.5%,92.5%and 46.2%,respectively,and the area under curve was 0.712 and 0.604,respectively.The sensitivity and specificity of Yu's book and CBC score of CVD classification were 0 and 15.8%,75.8%and 78.9%for protan CVD,and the Kappa values were-0.125 and 0.490.The sensitivity and specificity for deutan were 15.8%and 0,78.9%and 75.8%,with Kappa values as-0.125 and 0.490.The result of average detection time was as follows:Yu's book<CBC score<FM-100.Conclusion Yu's book can quickly screen for CVD and preliminarily determine the severity,and CBC score has a certain ability to assess the classification and severity with stable results,which is short time-consuming and difficult for cheating,with certain clinical application prospects.

关 键 词：先天性色觉异常 俞自萍色盲本 Color Blind Check评分 FM-100色觉检测 

分 类 号：R77[医药卫生—眼科]