摘要
目的 评价O＇Leary-Sant问卷表在间质性膀胱炎（IC）的诊断及鉴别诊断中的应用价值.方法 回顾性分析2008年1月1日至2013年3月31日因反复尿频、尿急、排尿费力、憋尿时耻骨上膀胱区疼痛于北京朝阳医院泌尿外科门诊初步考虑IC并应用O＇Leary-Sant问卷表对症状进行评估的患者资料.根据最终的临床诊断结果将患者分为IC组和非IC组,比较两组患者之间的O＇Leary-Sant评分（OPSI评分）、及其中的问题指数评分（ICPI评分）和症状指数评分（ICSI评分）的分布情况,并分别绘制相应的受试者工作特征（ROC）曲线,分别评价其在IC诊断中的特异性和敏感性.结果 共收集82例患者,其中IC组58例,非IC组24例.IC组和非IC组的OPSI评分分别为（24.7±6.9）和（23.2±7.8）分（P=0.403）,ICPI评分分别为（11.7±3.2）和（10.2±3.7）分（P=0.070）,ICSI评分分别为（13.0±4.0）和（13.1±4.3）分（P=0.975）,差异均无统计学意义.若以OPSI评分≥12分诊断IC,其敏感度为98%,特异度为8%,敏感度非常高,可将OPSI作为筛查IC的一项工具.在ROC曲线中,OPSI 、ICPI和ICSI评分的曲线下面积分别为0.548±0.071、0.622±0.069、0.492±0.070,这三项指标对IC的诊断价值均不高.结论 O＇Leary-Sant问卷表诊断IC敏感性高,特异性低,作为诊断IC工具其诊断价值不高.以OPSI评分≥12分筛选IC,其敏感性高,有一定临床价值.
Objective To evaluate the efficiency of O＇Leary-Sant problem index and symptom index （OPSI） in the diagnosis of interstitial cystitis （IC）. Methods A total of 82 patients, initially diagnosed as IC, with urinary frequency, urgency and pain on pubic area during bladder filling phase from January 2008 to March 2013 were enrolled. OPSI was used to evaluate their symptoms. They were eventually divided into IC and non-IC groups according to the clinical diagnosis. The scores of OPSI, interstitial cystitis problem index （ICPI） and interstitial cystitis symptom index（ICSI） were compared between two groups. And the ROC curve was plotted to screen the diagnostic specificity and sensitivity. Results Among them, 58 were diagnosed with IC and the rest with non-IC. The average score of OPSI for groups IC and non-IC were 24. 7 ± 6. 9 and 23.2 ±7.8 respectively （P = 0. 403 ）. And the ICPI score for two groups were 11.7 ± 3.2 and 10. 2 ± 3.7 （P = 0. 070 ） and the ICSI score 13.0 ± 4. 0 and 13.1 ± 4. 3 （ P = 0. 975 ） respectively. No significant differences existed between two groups. If an OPSI score of 12 or greater for diagnosing IC, the sensitivity was 98% and specificity 8%. Because of a high sensitivity, OPSI was a useful indicator for screening IC patients from others. In the ROC curve, acreage under curve for OPSI, ICPI, ICSI were 0. 548 ± 0. 071, 0. 622 ± 0. 069 and 0. 492 ± 0. 070 respectively. These three indices were not good indicators for diagnosing IC. Conclusions The O＇ Leary-Sant symptom index and problem index has a high sensitivity but a low specificity in the diagnosis of IC. Therefore it should not be used to differentiate interstitial cystitis. A cutoff OPSI value of 12 may be used for differentiation.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第42期3347-3350,共4页
National Medical Journal of China
关键词
膀胱炎
间质性
诊断
问卷调查
Cystitis,interstitial
Diagnosis
Questionnaires
