ROC曲线对原发性胆汁性肝硬化患者预后诊断阈值的确定及意义

赵丹彤; 廖慧钰; 刘燕敏; 黄春洋; 张海萍; 孙丽梅; 马胤雪; 赵艳; 闫惠平

doi:10.3969/j.issn.1001-5256.2014.01.017

ROC曲线对原发性胆汁性肝硬化患者预后诊断阈值的确定及意义

DOI: 10.3969/j.issn.1001-5256.2014.01.017

1. 首都医科大学附属北京佑安医院自身免疫性肝病临床研究中心
2. 首都医科大学附属北京佑安医院肝病免疫科

基金项目:

首都卫生发展科研专项项目(首发2011-2018-05)；

详细信息

中图分类号: R575.22
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出版历程
- 收稿日期: 2013-05-08
- 出版日期: 2014-01-20

ROC analysis of prognostic factors in Chinese patients with primary biliary cirrhosis

Clinical Research Center for Autoimmune Liver Disease, Beijing You'an Hospital, Capital Medical University

Research funding:

摘要

摘要:
目的采用受试者工作特征（ROC）曲线确定原发性胆汁性肝硬化（PBC）患者生存预后诊断阈值并评价其临床意义。方法以2001年10月至2009年9月北京佑安医院收治的155例确诊PBC患者为研究对象,进行随访,随访终点事件为死亡和（或）进行肝移植。对患者临床资料进行分析,符合正态分布的定量资料采用独立样本t检验,偏态分布的定量资料采用Wilcoxon秩和检验;计数资料采用χ2检验;偏态分布定量资料或分类变量资料采用Spearman秩相关分析法。采用ROC曲线确定预后诊断指标及阈值,采用Kaplan-Meier法进行组间生存率,评价临床意义。结果随访中位时间为50个月（6316个月）,36例患者出现终点事件（33例患者死亡,3例患者进行了肝移植）。年龄≥55岁、TBil>1.8 mg/dl、血清总IgG>17.2 g/L、Mayo评分（MRS）>6.11对肝硬化阶段PBC患者具有预后诊断价值;4项指标作联合分析,串联的特异度可达99.18%,灵敏度为5.56%,总符合率为79.23%;并联时,其灵敏度可达100%,特异度为24.51%,总符合率为40....
- 肝硬化,胆汁性 /
- ROC曲线 /
- 存活率分析 /
- 预后
Abstract:
Objective To investigate and assess prognostic factors for survival in patients with primary biliary cirrhosis ( PBC) by receiver operating characteristics ( ROC) curves and Kaplan- Meier methods. Methods A total of 155 patients were identified and followed. Terminal events were death and / or liver transplantation. The optimal thresholds for continuous variables were established by ROC curves and cumulative proportions of patients developing an event were estimated using the Kaplan- Meier method. Results During a median follow- up period of 50 months ( range: 6- 316) , 36 patients died or underwent liver transplantation. Age 55 years or older, Total Bilirubin ( TBil) > 1. 8mg / dl, serum IgG > 17. 2 g / L, and Mayo risk score ( MRS) > 6. 11 were associated with mortality. With four markers in series test, their sensitivity was 99. 18%, specificity was 5. 56%, the total coincidence rate was 79. 23%; With four markers in parallel test, their sensitivity was 100%, specificity was 24. 51%, the total coincidence rate was 40. 77%. Age 55 years or older ( P = 0. 001) , TBil > 1. 8mg / dl ( P = 0. 005) , serum IgG > 17. 2 g / L ( P = 0. 001) , and MRS > 6. 11 ( P < 0. 000 1) were significantly associated with mortality. Conclusion Age 55 years or older, TBil > 1. 8mg / dL, serum IgG > 17. 2 g / L, and MRS > 6. 11 might predict survival for PBC patients with liver cirrhosis.
- liver cirrhosis, biliary /
- ROC curve /
- survival analysis /
- prognosis

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