诊断16岁以上及以下大骨节病患者的主要临床标准的筛选分析

The screening analysis of the main clinical criterions to diagnose Kasch in -Beck Disease-in crude age groups between younger than 16and older than 16years old

目的筛选成人大骨节病的主要诊断指标,为进一步制定成人大骨节病诊断标准、大骨节病流行病学的防治研究提供科学的参考依据。方法利用单因素与多因素Logistic回归分析,对比分析了陕西省大骨节病病区16岁以上与16岁以下大骨节病患者的临床症状体征。结果(1)16岁以下组及16岁以上组临床指征阳性率比较的单因素分析显示,21项指标均有极显著性差异(P<0.001)。其中仅有3项指标(指末弯、干骺端与骨骺X线征)是16岁以下组高于16岁以上组,其余18项均为16岁以上组高于16岁以下组;(2)16岁以下组及16岁以上组大骨节病Logis-tic回归分析表明,16岁以下组检出大骨节病指末弯、X线干骺端、骨骺征象的概率显著高于16岁以上组,而关节痛、指粗、腕障碍、肘障碍和骨端五项临床指征的概率则显著低于16岁以上组。结论16岁以下年龄组,指末弯、骨骺、干骺端的X线征象等指征较为特异,而在16岁以上年龄段,关节痛、腕障碍、肘障碍、指粗、骨端等五项指征较为特异。

bjective To screen the main clinical criterio ns to diagnose Kaschin -Beck disease(KBD)in adu1ts,and to provide scientific evidence for e pidemiology,prevention and cure of KBD.Methods To compare the positive rate of 21cli ni-cal manifestations and X -ray signs o f KBD in crude age groups between younger than 16and older than 16years old by epidemi-ological methods of the single facto r analysis and the multiple factor Logistic regression analysis.Results(1)The results of single factor analysis showed that t he positive rate of 21clinical signs and symptoms of the KBD had significa ntly difference in those two crude age groups(P<0.001).Only the positive rates of flexion o f terminal finger,metaphyseal and e piphyseal le-sions of phalanges on the X -ray film i n the group who aged younger than 16we re higher than that in the group who aged older than 16among those clinical signs an d symptoms.(2)The multiple factor Logistic regression analysis showed that the positi ve rates of metaphyseal lesions and epi physis lesion of phalanges in hand on X -ray film and flexion of terminal finger in the group who aged younger than 16were higher t han that in the group who aged older th an 16(P<0.001),but the positive rates of arthritic pain,limited motion of wr ist,elbows,enlarged finger joints and the lesion of bone end on X -rays we re lower than that in the group who aged older than 16(P<0.001).Conclusion The results indicated that the 5item s of clinical index,such as arthritic pain,limited motion in wrists,elbows,enlarged finger joints and lesion of phalanges in bone en d on X -rays,can be regarded as the specific diagnostic criteria to diagnose KBD in the group aged older than 16years old while metaphyseal lesions of phalanges,epiphysis lesion and f lexion of terminal finger in the grou p aged younger than 16years old.[