危险因素记分法筛检无症状糖尿病及其评价

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目的 建立自然人群中无症状糖尿病的筛检方法。方法 在非胰岛素依赖型糖尿病流行病学调查的基础上,分别选择两组人群进行危险因素记分法及其应用价值研究。人群A用于危险因素记分方法的建立,采用logistic回归分析筛选糖尿病的危险因素,根据危险因素的OR值确定不同变量的记分值,以累计记分值的大小判断个体患病的危险性,并以人群B的资料验证该方法进行人群筛检的真实性和有效性。结果 随着累计记分值的增加,人群中无症状糖尿病的患病风险亦随之增高,趋势性χ2检验具有非常显著的统计学意义(P<0.01)。当判别阈值定为7时,该方法对人群中无症状糖尿病筛检的灵敏度和特异度分别为74.30%和63.20%,阳性预测值为4.20%,阴性预测值达99.20%。结论 本法简便、易行、经济,有利于获得满意的受检率,可用于糖尿病个体和群体(社区)的患病危险度测定及健康教育,有望成为糖尿病人群筛检的有效和实用的方法。 Objective To establish a screening method for asymptomatic diabetes in natural populations. Methods On the basis of the epidemiological investigation of non-insulin-dependent diabetes mellitus, two groups of people were selected for the risk factor score method and its application value. Crowd A was used to establish the scoring method of risk factors. Logistic regression analysis was used to screen the risk factors of diabetes. The scores of different variables were determined according to the OR of risk factors. The risk of individual illness was judged by the size of cumulative scores. The data from population B was used to verify the authenticity and effectiveness of this method for population screening. Results As the cumulative score increased, the risk of asymptomatic diabetes in the population also increased, and the trend χ2 test had a very significant statistical significance (P<0.01). When the discriminant threshold was set to 7, the sensitivity and specificity of this method for screening for asymptomatic diabetes in the population were 74.30% and 63.20%, respectively. The positive predictive value was 4.20% and the negative predictive value was 99.20%. Conclusion This method is simple, easy and economical, and it is conducive to obtain a satisfactory rate of detection. It can be used to determine the risk of disease and health education of individuals and groups (communities) of diabetes. It is expected to be an effective and practical method for the screening of diabetics. .
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