应用ROC曲线评价PTH对慢性肾衰竭的诊断价值

摘要

目的 探讨甲状旁腺素(PT H)应用于慢性肾衰竭(CRF)的临床诊断价值.方法 选取2014年1月至2015年10月在四川省人民医院接受治疗的162例CRF患者作为CRF组,同时选取164例其他非慢性肾衰竭(NCRF)患者和167例健康体检者分别作为NCRF组和健康对照组,检测3组PT H水平,根据结果绘制受试者工作特征(ROC)曲线,评价其对CRF的诊断价值.结果 CRF组 PT H 水平明显高于健康对照组和NCRF组,差异有统计学意义(P<0.05);PT H对CRF的诊断界值为75.0 nmol/L时,ROC曲线下面积、灵敏度、特异度、阳性似然比和Youden指数分别为0.92、80.20%、97.80%、36.45和78.00.结论 PT H对CRF有较好的诊断价值,以75.0 nmol/L作为PT H诊断CRF的临床诊断界值,可提高临床诊断效率.%Objective To explore the clinical diagnostic value of parathyroid hormone(PT H)in the diagno-sis of chronic renal failure(CRF).Methods 162 cases of CRF patients who were treated in the Sichuan Pro-vincial People′s Hospital from January 2014 to October 2015 were selected as the CRF group,meanwhile 164 non-CRF(NCRF)patients and 167 persons undergoing healthy physical examination were selected as the NCRF group and the healthy control group respectively.The PTH level was detected in 3 groups.According to the detection results the receiver operating characteristic(ROC)curve was drawn,and the diagnostic value of PTH for CRF was evaluate.Results The PTH level in the CRF group was significantly higher than that in the NCRF group and healthy control group,the difference was statistically significant(P<0.05);when the di-agnostic cut off value of PT H for CRF was 75.00 nmol/L,the area under the ROC curve,sensitivity,specifici-ty,positive likelihood ratio and Youden index were 0.92,80.20%,97.80%,36.45 and 78.00 respectively.Con-clusion PT H has a good diagnostic value to CRF.With the cut off value of PT H for diagnosing CRF as 75.0 nmol/L,it can improve the efficiency of clinical diagnosis.