髂耻足三联试验与传统方法诊断骶髂关节功能障碍的效果对比分析

A comparative analysis of IPP test and traditional method on the diagnosis of sacroiliac joint dysfunction

目的通过与传统诊断方法的对比分析,探讨髂耻足三联试验在骶髂关节功能障碍诊断中的效果及临床意义。方法选择2018年6月至2019年3月门诊骶髂关节功能障碍患者(病例组) 30例和正常对照组30例,分别采用髂耻足三联试验和传统诊断方法进行骶髂关节功能障碍相关检查,最后以骶髂关节注射术来确定诊断。对比两种诊断方法对骶髂关节功能障碍诊断的敏感度、特异度、受试者工作特征曲线(receiver operating characteristic,ROC)曲线下面积以及敏感度差异。结果病例组患者和对照组受试者比较,性别(χ^2=0.287,P=0.592)、年龄(t=0.400,P=0.691)差异无统计学意义。传统方法诊断骶髂关节功能障碍的敏感度为33.3%,特异度96.7%,ROC曲线下面积为0.650 (P=0.046);髂耻足三联试验诊断骶髂关节功能障碍的敏感性为76.7%,特异性为96.7%,ROC曲线下面积为0.867(P<0.001)。两种诊断方法的诊断敏感度差异有统计学意义(χ^2=11.38,P=0.001)。结论骶髂关节功能障碍的髂耻足三联试验,具有更高的诊断敏感性,对于怀疑骶髂关节功能障碍的腰腿痛患者应进行全面的专科体格检查,早期诊断,避免漏诊,降低腰椎术后失败综合征的发生风险。

Objective To explore the effect and clinical significance of abbreviations for three clinical trials which include iliac pronation test,pubic tubercle tenderness test,and plantar fascia tenderness test(IPP test) on the diagnosis of sacroiliac joint dysfunction by comparing with traditional diagnostic methods.Methods From June 2018 to March 2019,30 patients with sacroiliac joint dysfunction and 30 normal controls were selected to receive the IPP method and traditional diagnostic method respectively,which including several examinations of sacroiliac joint dysfunction,finally,the diagnosis was confirmed by sacroiliac joint injection.The sensitivity,specificity,receiver operating characteristic(ROC) area and sensitivity of the two diagnostic methods for sacroiliac joint dysfunction were compared.Results There was no significant difference between the experimental group and the control group on sex(10 males,20 females: 12 males and 18 females)(χ^2= 0.287.38,P=0.592),and on age [(43.4±11.6) years vs(42.0±14.1) years](t=0.400,P =0.691).The sensitivity,specificity and area under ROC curve of the traditional method were 33.3%,96.7% and 0.650(P=0.046).The sensitivity,specificity and area under ROC curve of the IPP method were 76.7%,96.7% and 0.867 respectively(P<0.001).Also the sensitivity between the two diagnostic methods was significantly different(χ^2= 11.38,P=0.001).Conclusion The IPP method of sacroiliac joint dysfunction has higher diagnostic sensitivity.For patients suspected of sacroiliac joint dysfunction,comprehensive physical examination should be carried out to make early diagnosis,avoid missed diagnosis and reduce the risk of fail back surgery syndrome.