甘肃省隐性梅毒诊断报告准确性及其影响因素分析

Analysis on accurate diagnosis and influencing factors of latent syphilis in Gansu province

目的了解甘肃省隐性梅毒病例的报告质量,发现存在的问题,提出改进措施。方法采用分层抽样方法,选择甘肃省9个市(州)、13个县(市、区)的21家医疗机构报告的隐性梅毒病例进行准确性及影响因素调查,包括核对临床、实验室原始记录等,依据国家诊断标准进行判断。采用Excel 2007软件和SPSS 18.0统计软件进行统计分析,包括比例计算、单因素和多因素Logistic回归分析等。结果对2015年4月1日至2016年3月31日,甘肃省21家医疗机构报告的417例隐性梅毒病例进行调查,隐性梅毒病例诊断符合率为83.21%(347例)[95%可信区间(CI):79.60%~86.80%],报告准确率为81.06%(338例)(95%CI:77.29%~84.82%)。多因素Logistic回归分析结果显示,影响隐性梅毒病例诊断准确性的因素有2个:病例是否会诊[比值比(OR)=6.27,95%CI:1.90~20.73],是否为性病监测点医院(OR=5.48,95%CI:1.28~23.39)。结论甘肃省隐性梅毒的诊断和报告工作亟待规范,迫切需要加强培训和病例报告准确性监管工作,切实提高病例数据的质量。

Objective To understand the quality of reported cases of latent syphilis in Gansu province, and to find the existing problems so as to improve the diagnosis quality. Methods Stratified sampling method was used to investigate the accuracy and influencing factors of the latent syphilis cases reported from 21 medical institutions of Gansu province, including clinical labs, and the original records, according to the national diagnostic criteria. EXCEL 2007 software and SPSS 18 were used for statistical analysis, including the single factor and multi factor logistic regression analysis. ResultsA total of 417 latent syphilis cases was reported from 21 hospitals during April 1, 2015 to March 31, 2016. The diagnostic accuracy rate was 83.21%（347/417）（95%CI：79. 60%-86.80%）, and the accuracy of reporting was 81.06%（338/417）（95%CI：77.29%-84.82%）. Multivariate logistic regression analysis showed that 2 factors affected the accuracy of the latent syphilis case report including whether the case got the consultation of doctors（OR=6.27, 95% CI：1.90-20.73）, and whether the hospital was the surveillance for venereal diseases（OR=5.48, 95% CI：1.28-23.39）. Conclusion The diagnosis and reporting of latent syphilis in Gansu province need to be standardized, and it is urgent to strengthen the training and supervision of the accuracy of case reports, and to effectively improve the quality of case data.