血吸虫病B超诊断指标主成分分析及患病率评估

周艺彪; 赵根明; 顾弋安; 宁安; 韦建国; 高祖禄; 吴启龙; 姜庆五

Abstract

周艺彪,赵根明,顾弋安,宁安,韦建国,高祖禄,吴启龙,姜庆五.血吸虫病B超诊断指标主成分分析及患病率评估[J].Chinese journal of Epidemiology,2003,24(9):810-814

血吸虫病B超诊断指标主成分分析及患病率评估

Principal component analysis on ultrasound indexes of schistosomiasis and the assessment on prevalence rate

Received:September 29, 2002

DOI：

KeyWord: 日本血吸虫病超声显像诊断主成分分析患病率

English Key Word: Schistosomiasis Japonicum Ultrasonography Principal component analysis Prevalence rate

FundProject:

Author Name	Affiliation
ZHOU Yi-biao	江西省寄生虫病防治研究所
ZHAO Gen-ming	江西省寄生虫病防治研究所
GU Yi-an	江西省寄生虫病防治研究所
NING An	The Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
WEI Jian-guo	江西省寄生虫病防治研究所
GAO Zu-lu	The Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
WU Qi-long	The Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
JIANG Qing-wu	江西省寄生虫病防治研究所

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Abstract:

目的　探讨B超诊断日本血吸虫病的综合指标,评估居民患病率。方法　先对B超诊断指标进行主成分分析,再用ROC曲线对综合指标进行评价。结果　B超各指标单独诊断居民异常率低者只有 1.6 %,高者可达 5 9.5 %,差异具有显著性 (χ2 =6 31.1,P <0.0 1)。各指标互相之间以及它们与年龄之间的相关差异都有显著性 (P <0.0 5 )。用三个主成分就可以反映日本血吸虫病所致的肝脾受损程度,第一主成分是反映肝脏受损程度的因子,第二、三主成分是反映脾脏受损程度的因子,把这三个主成分加权得到一个综合指标D1=0.0 4 7X1+0.4 2 8X2 +1.2 4 7X3 +0.0 95X4+0.0 0 2X5+0.2 13X6- 12.837,其ROC曲线下的面积为 0.95 7,当取D1=- 1.70为临界值时,人群中B超异常率为6 6.3%,与居民实际患病率为 6 6.9%非常接近。结论　B超检查可以作为快速评估日本血吸虫病流行区居民患病率的方法,并为化疗策略的实施提供有力的依据。

English Abstract:

Objective To explore the synthetical index for diagnosing schistosomiasis with ultrasound and to assess the prevalence rate with the index.Methods Ultrasound indexes of schistosomiasis Japonicum were analyzed by principal component analysis, and the synthetical indexes were assessed by ROC curve. Results Among the abnormal rates of the 6 indexes, the lowest was 1.6 % comparing with the highest of 59.5 %. Significant difference was noficed among the abnormal rates ( χ 2= 631.1, P 0.01 ). The individual correlation of the six indexes to each other as will as with age distribution was significant ( P 0.05 ). The three principal components reflected the degree of pathological changes on liver and spleen. The first principal component was the factor reflecting the degree of liver pathological changes, and the second and third principal components reflected the degree of pathological changes on spleen.The synthetical index D_1= 0.047X_1+ 0.428X_2+ 1.247X_3+ 0.095X_4+ 0.002X_5+ 0.213X_6- 12.837 was found by adding the three weight principal components, and it's area under the ROC curve was 0.957. When -1.70 was taken as the critical value, the abnormal rate of population was 66.3 %, close to the resident's actual prevalence rate 66.9 %. Conclusion Ultrasonography was considered as a method which could rapidly assessing the resident's prevalence rate in the endemic areas of schisitosomiasis Japonicum, and could also provide powerful information for development of strategy on chemotherapy.

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