本文選題：嗜酸粒細胞鼻息肉 + logistic回歸分析��； 參考：《華中科技大學(xué)》2011年碩士論文

【摘要】：目的:為尋找診斷嗜酸粒細胞鼻息肉的簡便方法,對外周血嗜酸粒細胞值并結(jié)合其他臨床指標的診斷價值進行分析,試圖確定一個最佳的臨界值來對國人伴鼻息肉的慢性鼻-鼻竇炎進行嗜酸粒細胞和非嗜酸粒細胞的分類。 方法:收集2004年-2010年雙側(cè)伴鼻息肉的慢性鼻-鼻竇炎患者共133例,其中通過HE染色將組織區(qū)分為嗜酸粒細胞鼻息肉(Eos CRSwNP)52例和非嗜酸粒細胞鼻息肉(non-Eos CRSwNP)81例。然后通過對嗜酸粒細胞鼻息肉和非嗜酸粒細胞鼻息肉兩組患者的性別、年齡、有無哮喘病史、變應(yīng)性鼻炎病史、病程、癥狀VAS評分、息肉評分、Lund-Macky CT評分、IgE、變應(yīng)性體質(zhì)檢測等多種因素分別進行單因素的logistic回歸分析,通過p值,優(yōu)勢比(OR),篩選出一個和(或)兩個對區(qū)分Eos CRSwNP和non-Eos CRSwNP有預(yù)測意義的指標,衡量其預(yù)測能力的大小。接著選取有預(yù)測意義的指標進行受試者工作特征曲線(ROC)曲線分析,通過曲線下面積直觀的判斷分界值與靈敏度和特異度的關(guān)系,并找到合適的切入點即分界值,進一步區(qū)分Eos CRSwNP和non-Eos CRSwNP。最后用所選的分界值對另一組獨立樣本的數(shù)據(jù)進行預(yù)測,并進一步分析其陽性預(yù)測值和陰性預(yù)測值,從而判斷分界值的預(yù)測效果。 結(jié)果:性別,外周血嗜酸粒細胞絕對值,外周血嗜酸粒細胞百分比,外周血IgE評分在Eos CRSwNP和non-Eos CRSwNP中比較有差異,外周血嗜酸粒細胞絕對值和百分比p0.001,且OR值較大,當(dāng)外周血嗜酸粒細胞絕對值在0.215×109/L,靈敏度和特異度分別為69.2%和76.5%。外周血嗜酸粒細胞百分比為2.65%時,靈敏度和特異度分別為76.9%和64.2%。當(dāng)嗜酸粒細胞絕對值0.145×109/L且IgE為12.1ku/l時,診斷的靈敏度和特異度為80%和85.2%,當(dāng)嗜酸粒細胞百分比為2.65%且IgE12.1ku/l時,診斷的靈敏度和特異度為80%和81.5%。 結(jié)論:通過對性別,外周血嗜酸粒細胞絕對值,外周血嗜酸粒細胞百分比及外周血IgE的綜合分析,可以對嗜酸粒細胞性鼻息肉進行初步的篩選。
[Abstract]:Objective: to find a simple method for the diagnosis of eosinophil nasal polyps and to analyze the diagnostic value of eosinophils in peripheral blood combined with other clinical indexes. An attempt was made to determine an optimal threshold for the classification of eosinophil and non-eosinophil in Chinese chronic rhinosinusitis with nasal polyps. Methods: a total of 133 cases of chronic rhinosinusitis with nasal polyps were collected from 2004 to 2010. The tissues were divided into eosinophil nasal polyps (Eos CRSwNP)52) and non-eosinophil nasal polyps (non-Eos CRSwNP)81) by HE staining. Then, the sex, age, history of asthma, history of allergic rhinitis, course of disease, symptom VAS score of patients with eosinophil nasal polyps and non-eosinophil nasal polyps were evaluated. Polyp score Lund-Macky CT score IgE, allergic constitution test and other factors were analyzed by single factor logistic regression analysis. One and / or two predictors of Eos CRSwNP and non-Eos CRSwNP were screened by p and odds ratio. Measure its predictive power. Then the predictive indexes are selected to analyze the ROCcurve of the subjects, and the relationship between the boundary value and sensitivity and specificity is judged directly by the area under the curve, and the appropriate cut-in point is found, that is, the threshold value. Further distinguish Eos CRSwNP from non-Eos CRSwNP. Finally, the selected boundary value is used to predict the data of another group of independent samples, and the positive predictive value and the negative predictive value are further analyzed to judge the prediction effect of the boundary value. Results: sex, absolute value of peripheral blood eosinophil, percentage of peripheral blood eosinophil, IgE score of peripheral blood were different between Eos CRSwNP and non-Eos CRSwNP. The absolute value and percentage of eosinophil in peripheral blood were p0.001, and OR value was higher. When the absolute value of eosinophils in peripheral blood was 0.215 脳 109 / L, the sensitivity and specificity were 69.2% and 76.5%, respectively. When the percentage of eosinophils in peripheral blood was 2.65, the sensitivity and specificity were 76.9% and 64.2%, respectively. When the absolute value of eosinophil was 0.145 脳 109 / L and IgE was 12.1ku/l, the sensitivity and specificity of diagnosis were 80% and 85.2%, and when the percentage of eosinophil was 2.65% and IgE12.1ku/l, the sensitivity and specificity of diagnosis were 80% and 81.5%. Conclusion: sex, absolute value of eosinophil in peripheral blood, percentage of eosinophil in peripheral blood and IgE in peripheral blood can be used to screen eosinophil nasal polyps.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R765.25

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本文編號：1899133