特应性皮炎控制工具评估病情控制情况的有效性验证  

Validation of the atopic dermatitis control tool in assessing disease control

作　　者：刘雅妮 赵倩 刘源[1] 张俊艳[1] 王惠平[1] Liu Yani;Zhao Qian;Liu Yuan;Zhang Junyan;Wang Huiping(Department of Dermatovenereology,Tianjin Medical University General Hospital/Tianjin Institute of Sexually Transmitted Disease,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院皮肤性病科,天津性传播疾病研究所,天津300052

出　　处：《中华皮肤科杂志》2025年第2期154-160,共7页Chinese Journal of Dermatology

摘　　要：目的验证特应性皮炎控制工具(ADCT)评估AD病情控制情况的有效性。方法采用横断面研究方法,收集2021年6月至2023年3月于天津医科大学总医院就诊的AD患者的人口学资料、共患病情况及特应性皮炎控制工具(ADCT)、瘙痒数字评价量表(NRS)、患者湿疹自我检查评分量表(POEM)、皮肤病生活质量指数(DLQI)等疾病评估相关量表信息,通过信度和效度分析验证ADCT的有效性。在POEM应答分类(清除或几乎没有、轻度、中度、重度、极重度)和DLQI应答分类(无影响、影响小、影响中等、影响很大、影响极大)的基础上,通过比较POEM和DLQI相邻患者亚组间ADCT总分平均值的差异来检验ADCT总分的判别能力。根据ADCT评分,将AD患者分为AD未控制组(ADCT评分≥7分)和AD控制组(ADCT评分<7分),比较两组在ADCT各条目、皮肤瘙痒平均NRS评分、POEM总分、DLQI总分及DLQI各维度评分的差异,以评价ADCT在评估AD患者疾病控制情况的有效性。结果共纳入338例AD患者,男170例(50.30%),女168例(49.70%),年龄17~89(41.36±17.63)岁。信度分析显示,ADCT量表的Cronbach′sα系数和折半信度分别为0.886和0.878(均>0.7),重测信度为0.977(>0.7,P<0.001)。内容效度分析显示,ADCT各条目与ADCT总分的Pearson相关系数为0.753~0.852(均P<0.001);验证性因子分析显示,卡方/自由度比值(χ^(2)/df)=2.896(<5),Tucker-Lewis指数为0.976(>0.9),比较拟合指数为0.991(>0.9),均方根残差为0.026(<0.08),近似误差均方根为0.075(<0.08);聚合效度分析显示,所有观察变量标准化后的因子载荷范围为0.689~0.905(均>0.500),组合信度为0.896(>0.700),平均变异抽取量为0.591(>0.500);效标效度分析显示,ADCT总分与其他患者报告结局指标评分(平均NRS评分、峰值NRS评分、POEM总分、DLQI总分)及DLQI各维度评分的相关系数范围分别为0.649~0.730和0.303~0.647,均P<0.001。ADCT总分判别能力分析显示,POEM相邻亚组和DLQI相邻亚组间ADCTObjective To verify the validity of the atopic dermatitis control tool(ADCT)in assessing disease control in patients with atopic dermatitis(AD).Methods Based on a cross-sectional study,demographic data,comorbidities and information on disease assessment-related scales such as the ADCT,the pruritus numerical rating scale(NRS),the patient-oriented eczema measure(POEM),and the dermatological life quality index(DLQI)were collected from patients with AD at Tianjin Medical University General Hospital from June 2021 to March 2023.The reliability and validity of the ADCT were assessed using these data.The discrimination power of the ADCT total score was evaluated by comparing the differences in the mean ADCT total scores among adjacent POEM/DLQI subgroups based on POEM/DLQI response classifications(POEM:clear or almost absent,mild,moderate,severe,very severe;DLQI:no effect,mild effect,moderate effect,serious effect,very serious effect).According to the ADCT scores,the AD patients were divided into an uncontrolled AD group(ADCT scores≥7 points)and a controlled AD group(ADCT scores<7 points).Differences between the above two groups were analyzed in terms of ADCT item scores,mean pruritus NRS scores,POEM total scores,DLQI total scores,and DLQI dimension scores to evaluate the validity of the ADCT in assessing AD disease control.Results A total of 338 patients with AD were included,comprising 170(50.30%)males and 168(49.70%)females,and they were aged 17 to 89(41.36±17.63)years.Reliability analysis showed that the Cronbach′sαcoefficient and split-half reliability coefficient of the ADCT were 0.886 and 0.878 respectively(both>0.70),and the test-retest reliability coefficient was 0.977(>0.70,P<0.001).Content validity analysis showed that the Pearson correlation coefficients between the ADCT item scores and the ADCT total score ranged from 0.753 to 0.852(all P<0.001);confirmatory factor analysis revealed that the Chi-square to degree of freedom ratio(χ^(2)/df)was 2.896(<5),the Tucker-Lewis index was 0.976(>0.9),the compar

关 键 词：皮炎 特应性 特应性皮炎控制工具 信度 效度 疾病控制 验证 

分 类 号：R758.2[医药卫生—皮肤病学与性病学]