摘要
背景:溃疡性结肠炎(UC)病情严重程度的判定对于药物治疗方案的选择以及疗效和预后评估至关重要。目的:建立对UC病情严重程度进行量化判定的判别方程式并验证其有效性。方法:回顾性纳入北京市海淀医院169例次活动期UC病例,以Truelove-Witts标准为基础,选择7个国际公认的指标:体温、脉搏、排便次数、便血、血红蛋白(Hb)、红细胞沉降率(ESR)、白蛋白(Alb)进行逐步选择判别分析,判别方程式选择Fisher线性判别函数,并对其进行验证。结果:得到判别方程式:F1(轻度)=-51.109+0.587X1+0.295X2+0.379X3+0.071X4;F2(中度)=-49.905+0.624X1+0.512X2+0.333X3+0.095X4;F3(重度)=-57.294+0.709X1+0.599X2+0.296X3+0.141X4。其中X1为脉搏(次/min),X2为排便次数(次/d),X3为Hb(g/L),X4为ESR(mm/h)。判别方程式的判别结果与Truelove-Witts标准分级中度相关(rs=0.683,P<0.001),其对中度UC的判别能力优于Truelove-Witts标准,对轻度UC的判别能力优于活动性指数(AI)。其可信性亦经由分析验证。结论:本研究建立的判别方程式对UC病情严重程度的判别能力优于Truelove-Witts标准和AI标准,但其临床实用性尚需多中心前瞻性研究确认。
Background:Assessment of disease severity of ulcerative colitis(UC)is crucial for the decision of drug treatment strategy,the appraisal of response to drugs,and the prognosis evaluation.Aims:To establish and validate a discriminant model for the quantification of disease severity of UC.Methods:The clinical data of 169 active UC cases admitted at the Beijing Haidian Hospital were analyzed retrospectively.Based on Truelove-Witts criteria,seven widely accepted indices including temperature,pulse,defecation frequency,hematochezia,hemoglobin(Hb),erythrocyte sedimentation rate(ESR)and albumin(Alb)were selected and a stepwise discriminant analysis was performed to establish a discriminant model using Fisher’s linear discriminant function,and then the discriminant model was validated from different aspects.Results:The discriminant model:F1(mild)=-51.109+0.587X1+0.295X2+0.379X3+0.071X4;F2(moderate)=-49.905+0.624X1+0.512X2+0.333X3+0.095X4;F3(severe)=-57.294+0.709X1+0.599X2+0.296X3+0.141X4[X1,pulse(beats/min);X2,defecation frequency(times/d);X3,Hb(g/L);X4,ESR(mm/h)].The result of the newly established discriminant model was moderately correlated with the Truelove-Witts criteria(r_(s)=0.683,P<0.001).Its discriminating power for moderate UC was superior to Truelove-Witts criteria,and for mild UC was superior to activity index(AI).The reliability of the newly established discriminant model was also analytically verified.Conclusions:The discriminating power for disease severity of UC of the newly established discriminant model is better than that of Truelove-Witts criteria and AI criteria.Its clinical practicability,however,needs to be further confirmed in multicenter prospective studies.
作者
王怀唐
郭银燕
WANG Huaitang;GUO Yinyan(Department of Gastroenterology, Beijing Haidian Hospital, Haidian Section of Peking University Third Hospital, Beijing 100080)
出处
《胃肠病学》
北大核心
2021年第3期134-138,共5页
Chinese Journal of Gastroenterology
关键词
结肠炎
溃疡性
病情严重程度
量化标准
判别分析
Colitis,Ulcerative
Disease Severity
Quantitative Criteria
Discriminant Analysis
