摘要
目的分析改良Coston法的诊断效能及可重复性,并比较改良前、后睑缘蠕形螨检出特征。设计诊断技术评价。研究对象2018年北京同仁医院临床拟诊为蠕形螨性睑缘炎患者131例。方法传统及改良Coston法均自患者双眼上、下睑睑缘三个位置(内侧、中央、外侧)处,各拔取睫毛一根(选择距离睑板腺开口最近的睫毛)。传统Coston法为直接拔出睫毛,改良Coston法为环绕毛囊的螺旋式拔出。睫毛拔下后镜检并计算毛囊蠕形螨各期虫体总数。78例进行改良前后检出特征比较研究,53例进行改良Coston法可重复性分析。所有取样均由同一位具有相关经验的技师操作。采用SPPS20.0对各参数进行统计学描述、比较蠕形螨检出量及阳性率,计算并分析组内相关系数(intraclass correlation coefficient,ICC)值;采用R语言软件比较不同取样的ROC曲线下面积(area under curve,AUC)。主要指标ICC、AUC、毛囊蠕形螨的阳性率、检出率、检出量。结果改良Coston法的重复性较高,ICC=0.874,AUC=0.944。取样2根(中央+外侧)时的AUC值与取样3~5根时的差异无统计学意义(P<0.05),且前者可重复性最高(ICC=0.897)。改良后的阳性率及总检出量(82.1%,499.7只)均高于改良前(66.7%,437.28只)(P=0.028,0.000)。结论改良Coston法拔睫毛镜检的诊断效能高、可重复性好,且可提高蠕形螨检出率。中央及外侧共取样2根的精减取样组合,与传统的内、中、外侧共取样3根的方法相比,具有相似的诊断效力。
Objective To analyze the diagnostic efficiency and reproducibility of modified Coston method,and to compare the detection characteristics of conventional Coston method and modified Coston method in demodex blepharitis patients.Design Diagnostic technique evaluation.Participates 131 patients visiting Beijing Tongren Eye Center,suspected of demodex blepharitis,were continuously collecting in 2018.Methods One eyelash at each of the three positions(medial,central,and lateral side)of palpebral margin from each eyelid(selecting the eyelash closest to the orifice of the meibomian gland)were sampled by both conventional and modified Coston method.The conventional Coston method was to pull out the eyelashes directly,while the modified Coston method was a spiral pull-out manipulation rotating around the hair follicle.After the eyelashes were removed,the microscopic examination was performed and the total number of demodex of different stages were calculated.From January to July,78 patients were collected for comparing the detection characteristics between conventional and modified method.53 patients from August to December were collected for analysis of reproducibility of the modified Coston method.All lashes were sampled by a technician with relevant experience.SPPS 20.0 was applied for descriptive statistics of various parameters,comparing positive rate and detection amount,and calculating intraclass correlation coefficient(ICC)value;R language software was applied to compare area under curve(AUC)values of different sampling combinations.Main Outcome Measures ICC,AUC,positive rate,detection rate and detection amount of demodex folliculorum.Results The ICC of modified method was 0.874,AUC was 0.944.There was no statistically significant difference between the AUC values of sampling of central and lateral sides and that of sampling 3-5 lashes(P<0.05),and the former was most reproducible(ICC=0.897).The positive rate and total detection amount of modified method(82.1%,499.7 mites)were higher than that of conventional method(66.7%,437.28 mites)(P=0.028,0.000).Conclusion The modified Coston method of rotating manipulation before epilation with better repeatability can increase the detection rate of demodex.Simplified sampling combination of 2 lashes from central and lateral sides per eyelid had similar diagnostic performance compared with 3 lashes sampled in traditional Coston method.
作者
张阳
韦振宇
王智群
曹凯
梁庆丰
鲁辛辛
ZHANG Yang;WEI Zhen-yu;WANG Zhi-qun;CAO Kai;LIANG Qing-feng;LU Xin-xin(Beijing Institute of Ophthalmology,Beijing Tongren Eye Centre,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing Tongren Hospital,Capital Medical University,Beijing 100005,China;Laboratory Department,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)
出处
《眼科》
CAS
2019年第6期409-413,共5页
Ophthalmology in China
基金
北京市百千万人才工程培养基金(2017A10)
