计算机动态姿势图识别伪装平衡功能障碍

Identifying Malingering Symptoms of Balance Disorders by Computerized Dynamic Posturography

目的建立本实验室用动态姿势图识别非器质性或伪装平衡功能障碍的客观方法。方法对104例正常受试者行动态姿势图检查后指导其伪装平衡功能障碍再进行动态姿势图检查,将伪装前后的平衡分进行配对t检验;应用以往研究提示伪装的7条标准对本实验的50例伪装前后的姿势图表现(包括原始曲线)进行判别,按照90%的敏感性选取并建立本实验室识别伪装者的判断方法,并用余54例样本对新的判断方法进行回代检验。结果伪装前后的动态姿势图的差异有统计学意义(P<0.01),伪装后姿势稳定性明显低于伪装前;本次建立的识别伪装方法特异性和敏感性分别为92.5%和98.2%。结论在分析动态姿势图的平衡分时有必要先进行伪装识别,本实验室的判断方法具有较高的准确性和较好的实用性。

Objective To develop an objective criteria with computerized dynamic posturography（CDP） for identification of non-organic or malingering symptoms of balance disorders.Methods One hundred and four normal subjects were instructed to feign balance disturbance after naturally performing on CDP.Paired t-test was used to determine if there was significant difference of CDP equilibrium scores between normal and malingering performance.The CDP records including raw curve of 50 subjects were critically evaluated by previously published seven criteria in indicating malingering performance.If the sensitivity of a criterion was greater than 90%,it would be accepted as our laboratory＇s identifying criterion.The CDP records of remaining 54 subjects were used to test the sensitivity and specificity of the accepted criteria.Results There were statistically significant differences of CDP equilibrium scores between normal and malingering performance（P0.01）.The mean equilibrium scores of malingering performance were lower than that of normal performance.The sensitivity and specificity of our criteria for identifying malingerers were 92.5% and 98.2%,respectively.Conclusion It is necessary to identify malingering performance before analyzing the CDP equilibrium scores.Our identifying criteria of malingerers seems to be quite useful and accurate.