Yu Fang Fang, Ping Zhi Guang, Yao Chong, Wang Zhi Wen, Wang Fu Qi, Guo Xiong
Institute of Endemic Diseases, School of Public Health of Health Science Center, Xi'an Jiaotong University, Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, Xi'an 710061, Shaanxi, China.
Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 45001, Henan, China.
Biomed Environ Sci. 2017 Feb;30(2):150-155. doi: 10.3967/bes2017.021.
This study aimed to evaluate the sensitivity and specificity of the new clinical diagnostic and classification criteria for Kashin-Beck disease (KBD) using six clinical markers: flexion of the distal part of fingers, deformed fingers, enlarged finger joints, shortened fingers, squat down, and dwarfism. One-third of the total population in Linyou County was sampled by stratified random sampling. The survey included baseline characteristics and clinical diagnoses, and the sensitivity and specificity of the new criteria was evaluated. We identified 3,459 KBD patients, of which 69 had early stage KBD, 1,952 had stage I, 1,132 had stage II, and 306 had stage III. A screening test classified enlarged finger joints as stage I KBD, with a sensitivity and specificity of 0.978 and 0.045, respectively. Shortened fingers were classified as stage II KBD, with a sensitivity and specificity of 0.969 and 0.844, respectively, and dwarfism was classified as stage III KBD with a sensitivity and specificity of 0.951 and 0.992, respectively. Serial screening test revealed that the new clinical classification of KBD classified stages I, II, and III KBD with sensitivities of 0.949, 0.945, and 0.925 and specificities of 0.967, 0.970, and 0.993, respectively. The screening tests revealed that enlarged finger joints, shortened fingers, and dwarfism were appropriate markers for the clinical diagnosis and classification of KBD with high sensitivity and specificity.
本研究旨在利用手指远端屈曲、手指变形、手指关节肿大、手指缩短、下蹲和身材矮小这六种临床指标，评估大骨节病（KBD）新的临床诊断和分类标准的敏感性和特异性。采用分层随机抽样方法抽取了麟游县三分之一的总人口。该调查包括基线特征和临床诊断，并对新标准的敏感性和特异性进行了评估。我们共识别出3459例大骨节病患者，其中69例为早期大骨节病，1952例为I期，1132例为II期，306例为III期。一项筛查试验将手指关节肿大归类为I期大骨节病，其敏感性和特异性分别为0.978和0.045。手指缩短归类为II期大骨节病，其敏感性和特异性分别为0.969和0.844，身材矮小归类为III期大骨节病，其敏感性和特异性分别为0.951和0.992。系列筛查试验显示，大骨节病新的临床分类对I、II和III期大骨节病的分类敏感性分别为0.949、0.945和0.925，特异性分别为0.967、0.970和0.993。筛查试验表明，手指关节肿大、手指缩短和身材矮小是大骨节病临床诊断和分类的合适指标，具有较高的敏感性和特异性。
