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慢性非特异性肺病中肺动脉高压演变的长期研究的评估问题

Evaluation problems of a long-term study on evolving pulmonary arterial hypertension in chronic non specific lung disease.

作者信息

Naszlady A, Rodek I

出版信息

G Ital Cardiol. 1984;14 Suppl 1:49-55.

PMID:6534767
Abstract

After having collected a sufficient number of standardized data checked for reliability from patients with chronic non specific lung disease, the following subgroups of pulmonary arterial mean pressure were defined: A = PAP less than 2.7 kPa [= 20 mmHg]; B = 2.7 less than PAP less than 4 kPa; C = PAP greater than 4 kPa [= 30 mmHg]. Within these subgroups a diagnostic classification was also carried out: chronic obstructive lung disease, thrombo-embolic lung disease, diffuse interstitial lung disease. The aims of data processing were: clustering correctly individual cases in one of the I-II-III subgroups based on non-invasive variables only; To define equations predictive of quantitative values of pulmonary arterial mean pressure from non-invasive data; To find regularity of evolution of elevated pulmonary arterial mean pressure in chronic non specific lung disease and detect risk factors and/or beneficial interventions if such exist at all. Two different statistical methods were applied: conditional probability (Bayes theorem) and discriminant analysis. The predictive power of each depends mainly on the seriousness of signs and symptoms denoted by the medical user. Three probability-functions have been defined between severity of single variables and their specificity, sensitivity and probability of pulmonary hypertension. By application of these functions the user can select different quantitative values of variables which determine the proportion of false/true, positive/negative cases. After having chosen the desired values of these proportions, multivariate equations are defined by stepwise regression analysis optimized for predictive power.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在从慢性非特异性肺部疾病患者中收集了足够数量经可靠性检验的标准化数据后,定义了以下肺动脉平均压亚组:A = 肺动脉压(PAP)小于2.7 kPa [= 20 mmHg];B = 2.7<PAP<4 kPa;C = PAP大于4 kPa [= 30 mmHg]。在这些亚组内还进行了诊断分类:慢性阻塞性肺疾病、血栓栓塞性肺疾病、弥漫性间质性肺疾病。数据处理的目的是:仅基于非侵入性变量将个体病例正确聚类到I-II-III亚组之一;从非侵入性数据定义预测肺动脉平均压定量值的方程;找出慢性非特异性肺部疾病中肺动脉平均压升高的演变规律,并检测危险因素和/或有益干预措施(若确实存在)。应用了两种不同的统计方法:条件概率(贝叶斯定理)和判别分析。每种方法的预测能力主要取决于医学使用者所指出的体征和症状的严重程度。已经定义了单个变量的严重程度与其特异性、敏感性及肺动脉高压概率之间的三个概率函数。通过应用这些函数,使用者可以选择不同的变量定量值,这些值决定了假/真、阳性/阴性病例的比例。在选择了这些比例的期望数值后,通过为预测能力优化的逐步回归分析定义多变量方程。(摘要截选于250词)

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