利用ROC曲线分析泪膜破裂时间和泪液分泌试验在干眼症诊断中的应用

Application of ROC Curve in Tear Film Break Up Time and Schirmer Test in the Diagnosis of Dry Eye

目的利用ROC曲线分析的方法,探讨泪膜破裂时间(tear film break up time,BUT)和泪液分泌试验(schirmer test,ST)在诊断干眼症时的最佳临床临界值。方法 122位受访者进行了Saliabury干眼症问卷调查后行BUT检查及ST检查。根据主观干眼症状问卷结果进行干眼症诊断,对BUT及ST客观检验结果分别予ROC曲线统计分析评判。结果从BUT的ROC曲线中我们发现当临界值为5s时,其干眼症诊断的灵敏性为70%以上,特异性60%左右;而当BUT临界值为10秒时,其灵敏性可以达95%,但其特异性仅为25%左右。同样,从ST的ROC曲线中我们发现当临界值为10mm时,其灵敏性为55%以上,特异度63%左右;而当临界值为5mm时,其特异性可以高达95%以上,但其灵敏性仅为20%左右。BUT的ROC曲线下面积大于ST的ROC曲线下面积。结论从ROC曲线分析结果我们认为BUT取5.0s,ST取10mm时其诊断干眼的的灵敏性和特异性组合相对较佳;在诊断干眼时BUT的诊断效能比ST更高。

To investigate the clinical threshold of tear film break up time （BUT） and Schirmer test （ST） in the diagno- sis of dry eye by using ROC curve analysis. Methods 122 respondents of saliabury dry eye questionnaire underwent BUT examination and ST examination. Dry eye was diagnosed according to the results of questionnaire. The results of BUT and ST were analysed by ROC curves. Results According to ROC curve of BUT, the sensitivity of diagnosis of dry eye was more than 70% and the specificity was 60% when the threshold of BUT was 5 seconds. However, the sensitivity can be 95% , but specificity was only 25% when the critical value was 10 seconds. Similarly, according to ROC curve of ST, the sensitivity of diagnosis of dry eye was more than 55% and specificity was 63% when the threshold was lOmm. However, when the critical value was 5ram, the specificity of diagnosis of dry eye can be as high as 95% or more, but sensitivity was only about 20%. The area under the curve of BUT was greater than that of ST. Conclusion According to the results of ROC curve analysis, it is relatively better of combination of the sensitivity and specificity when BUT take 5.0 seconds and STtake lOmm to diagnose dry eye. The diagnostic performance of BUT is better than that of ST in diagnosis of dry eye.