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目的探讨贝叶斯判别分析在诊断原发性醛固酮增多症中的价值。方法收集2008年7月至2013年12月近5年重庆医科大学附属第一医院疑诊原发性醛固酮增多症(原醛)病例321例,分为原发性醛固酮增多症组和原发性高血压组。利用贝叶斯判别函数获取原醛分类函数系数及原醛后验概率,根据受试者工作特征曲线(ROC),获取最佳切点。进一步对此法及立位血浆醛固酮/肾素浓度比值(ARR)在原醛筛查中的价值进行对比。结果原醛后验概率为0.34时,其诊断原醛的灵敏度和特异度最高,分别为0.84、0.84,立位ARR切点取43.45时灵敏度和特异度达最高,分别为0.88、0.76,原醛后验概率的ROC曲线下面积为0.911(0.870-0.951),大于立位ARR曲线下面积0.893(0.845-0.941)。结论贝叶斯判别分析诊断原醛的价值优于立位ARR。
Objective To investigate the value of Bayesian discriminant analysis in the diagnosis of primary aldosteronism. Methods A total of 321 cases of suspected primary aldosteronism (primary aldosteronism) were collected from the first affiliated hospital of Chongqing Medical University from July 2008 to December 2013 in the past five years. The patients were divided into primary aldosteronism group and primary Hypertension group. The original aldehyde classification function coefficients and the original aldehyde posterior probability were obtained by Bayesian discriminant function. The best cut point was obtained according to the receiver operating characteristic curve (ROC). We further compared the value of this method with that of standing plasma aldosterone / renin concentration (ARR) in primary aldehyde screening. Results The positivity of the original aldehyde was 0.34, the sensitivity and specificity of the original aldehyde were the highest (0.84,0.84, respectively). The highest sensitivity and specificity were obtained when the upright position of ARR was 43.45 (0.88,0.76, respectively) The area under the ROC curve of posterior probability was 0.911 (0.870-0.951), which was larger than the area under the ARR curve of 0.893 (0.845-0.941). Conclusion Bayesian discriminant analysis of the value of the original aldehyde diagnosis is superior to standing ARR.