克罗恩病与肠结核鉴别诊断评分系统的建立

The establishment of differential diagnosis scoring system of Crohn's disease and intestinal tuberculosis

目的建立克罗恩病(Crohn's disease,CD)与肠结核(intestinal tuberculosis,ITB)鉴别诊断评分系统,并评价其鉴别诊断效能。方法参照CD与ITB诊断标准,确诊CD 35例,ITB 31例。收集两组患者临床表现、结肠镜检查、实验室检查和病理组织学检查等资料,对以上资料先进行单因素分析,筛选出有统计意义的变量,再行多因素Logistic回归分析,根据回归模型中的β值建立鉴别诊断评分系统。用受试者工作特性(ROC)曲线下面积检验评分系统的鉴别诊断效能。结果 PPD试验强阳性、裂隙状溃疡、环形溃疡、鹅卵石征、非干酪性肉芽肿被纳入多因素Logistic回归模型。根据模型中各变量的β值赋予分值并建立评分系统。该评分系统ROC曲线下面积95%可信限为0.759(0.637,0.880)。结论 CD与ITB鉴别诊断评分系统对两种疾病的鉴别诊断具有较好的区分度,值得进一步研究和推广。

Objective To establish the differential diagnosis scoring system of Crohn＇s disease（CD） and intestinal tuberculosis（ITB）, and to evaluate the differential diagnostic efficacy. Methods Reference CD and ITB diagnostic criteria, 35 cases of CD were diagnosed, and 31 cases of ITB were diagnosed. Clinical manifestation, colonoscopy, laboratory examination and pathological examination etc. were collected and carried out a single factor analysis to filter out the statistical significance of the variables, then multiple factors Logistic regression analysis was used on them. According to the β value of the regression model, the differential diagnosis scoring system was established. Area under the receiver operating characteristic（ROC） curve was used to test the differential diagnostic efficacy of scoring system. Results Strongly positive, slit like ulcer, annular ulcer, pebble sign, and Non-caseating granuloma of ppd test were included in multi factor Logistic regression model. According to theβ value of each variable in the model, scores were given and scoring system was established. The area under the ROC curve of the scoring system 95% confidence interval was 0.759（0.637, 0.880）. Conclusion The differential diagnosis scoring system of Crohn＇s disease（CD） and intestinal tuberculosis（ITB） has a better discrimination of the differential diagnosis of the two diseases. It is worthy of further research and promotion.