Shirata T, Miura H, Miyazawa K, Ouchi K
Rinsho Byori. 1989 Sep;37(9):1045-50.
In order to obtain a useful screening index for primary hyperparathyroidism (PHPT), seven patients with PHPT and fifty-one patients with nonparathyroid hypercalcemia (NPHC) were studied retrospectively. Serum calcium, inorganic phosphate (IP), alkaline phosphatase, albumin (Alb), chloride (Cl), total protein, urea nitrogen and creatinine (Cre) were analyzed at the same time. Discriminant analysis using a stepwise variable select method was applied to these patients. A discriminant function (F 1) was derived from three laboratory tests; F 1 = -0.660 x [IP] + 0.142 x [Cl] + 0.564 x [Alb] - 14.4 (PHPT: F 1 greater than 0.641). F 1 had sensitivity of 100% and specificity of 72.5% (14 false positives) in diagnosing PHPT. Next, another discriminant function (F 2) was derived from PHPT and the false positive patients; F 2 = -2.61 x [IP] + 0.286 x [Cl] - 4.24 x [Cre] - 19.3 (PHPT: F 2 greater than 0.412). When F 2 was applied to positive patients by F 1, final sensitivity was 100% and specificity was 98%. This screening method was tested prospectively in fifty-six consecutive samples of hypercalcemia (PHPT 4, NPHC 52), resulting in sensitivity of 100% and specificity of 98%. It was proved that our screening method using two step discriminant functions was very useful to diagnose PHPT.
为获得原发性甲状旁腺功能亢进症（PHPT）的有效筛查指标，对7例PHPT患者和51例非甲状旁腺性高钙血症（NPHC）患者进行了回顾性研究。同时分析血清钙、无机磷（IP）、碱性磷酸酶、白蛋白（Alb）、氯（Cl）、总蛋白、尿素氮和肌酐（Cre）。对这些患者采用逐步变量选择法进行判别分析。通过三项实验室检测得出判别函数（F1）；F1 = -0.660×[IP] + 0.142×[Cl] + 0.564×[Alb] - 14.4（PHPT：F1大于0.641）。F1在诊断PHPT时的敏感性为100%，特异性为72.5%（14例假阳性）。接下来，从PHPT患者和假阳性患者中得出另一个判别函数（F2）；F2 = -2.61×[IP] + 0.286×[Cl] - 4.24×[Cre] - 19.3（PHPT：F2大于0.412）。当将F2应用于F1判定为阳性的患者时，最终敏感性为100%，特异性为98%。该筛查方法在56例连续的高钙血症样本（4例PHPT，52例NPHC）中进行了前瞻性测试，敏感性为100%，特异性为98%。结果证明，我们采用两步判别函数的筛查方法对诊断PHPT非常有用。
