不同体位红外热成像检测对口咽部炎症的可行性分析

Comparative analysis of infrared thermal image on two different body postures in detecting pharyngeal inflammation

目的利用红外热成像技术,分别在正面位和仰面位两种不同体位下进行口咽部炎症检测,对比这两种体位检测对口咽部炎症的可行性分析。方法随机采集61例健康成年人,其中男性53例,女性8例;年龄18~29岁,平均年龄22.33岁。采用双盲法。应用红外热像检测仪,分别采集正面位和仰面位头面颈部红外热成像图,判断口咽部红外热成像表达阴性或阳性;检查咽喉,分为有体征和无体征。比较两种方法诊断口腔炎症的阳性率,并分别对两种体位检测进行灵敏度、特异度、预检率、假阳性率、假阴性率及诊断符合率的分析。结果临床诊断与红外正面位检测阳性率的差异无统计学意义（χ^2=1.002,P=0.317）,与红外仰面位检测阳性率的差异有统计学意义（χ2=4.659,P=0.031）。仰面位检测的灵敏度、阴性预检率、诊断符合率和假阴性率比正面位检测的明显增加（97.83%vs 76.09%,83.33%vs 45.00%,81.97%vs 72.13%,66.67%vs40.00%）,但特异度、阳性预检率和假阳性率下降（33.33%vs 60.00%,2.17%vs 23.91%,81.82%vs 85.37%）。结论仰位面红外热成像对口咽部炎症的检测优于正面位。此外,上呼吸道的红外热成像对如H7N9流感等重大呼吸性传染病大规模筛检体温可能会提高筛检率。

Objective To detect pharyngeal inflammation by infrared thermal image（IRTI） and compare the value of the IRTI acquired in upright-head-view or raising-head-view positions for the diagnosis of pharyngeal inflammation. Methods Total of 61 healthy adult were enrolled randomly, included 53 males and 8 females, aged 18 - 29 years old with median age of 22.23. The double blind method was adopted, the IRTI in upright-head-view or raising-head-view positions of 61 cases were acquired by the medical infrared thermograph instrument. And in accordance with the physical sign of pharynx, the cases were divided into 2 groups： positive and negative. The positive predictive value of IRTI was compared with that of clinical examination, and IRTI detections in 2 body postures were analyzed by sensitivity, specificity, pre-screening rate, false positive, false-negative and diagnose accordance rate. Results There was no statistically significant difference between clinical diagnosis and upright- head-view position IRTI（x^2 = 1.002, P = 0.317）, but there was statistically significant difference between clinical diagnosis and raising-head-view position IRTI（x^2 = 4.659, P = 0.031）. The sensitivity, negative pre-screening, diagnose accordance and false- negative rate in raising-head-view position were obviously higher than those acquired in upright-head-view position（97.83 % vs 76.09 %, 83.33 % vs 45.00 %, 81.97 % vs 72.13 % and 66.67 % vs 40.00 %）, and specificity, false positive and positive pre- screening rate were decreased （33.33 % vs 60.00 %, 2.17 % vs 23.91% and 81.82 % vs 85.37 %）. Conclusion The raising- head-view position detection is better than the upright-head-view position detection in monitoring pharyngeal inflammation. In addition, the upper respiratory tract monitoring by IRTI may increase screening rates in major respiratory infectious diseases such as H7N9 influenza outbreak.