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[摘要]
目的:应用Logistic多元回归分析和ROC曲线探讨年龄因素对诊断儿童子午线弱视有无影响。
方法:研究对象为2008/2011年间在我院眼科门诊就诊,以散光为主要屈光异常并排除屈光参差及斜视的4~8岁儿童共1 005例1 910眼。采用Logistic多元回归分析年龄、性别、柱镜绝对值程度、球镜绝对值程度、散光类型对诊断子午线性弱视的影响,通过ROC曲线下面积(area under the ROC curve,AUC)分析进一步明确患者年龄因素对诊断子午线弱视的影响。
结果:分别建立Logistic 回归模型1(包括性别、柱镜绝对值程度、球镜绝对值程度、散光类型四个变量)和模型2(前四个变量再加上年龄)。两个模型的Logistic 回归分析都提示柱镜绝对值程度是诊断子午线性弱视的影响因素,模型2 的Logistic 回归分析同时提示年龄是诊断子午线性弱视的影响因素。模型1的AUC为0.64,模型2的AUC为0.74,两者比较有统计学差异(P<0.05), 表明不同年龄儿童ROC的灵敏度和特异度存在一定差异。
结论:运用Logistic回归和ROC曲线综合分析结果表明,在儿童子午线性弱视诊断中,需要充分考虑患者年龄因素对诊断的影响。
[Key word]
[Abstract]
AIM: To assess the diagnostic value of age for meridional amblyopia by Logistic regression and receiver operating characteristic(ROC)curve.
METHODS: A total of 1 005 children(1 910 eyes)with unknown ocular abnormalities other than with-the-rule astigmatism(aged 4-8 years)were recruited. Astigmatism >or =1.00D and sphere < or = 3.00D were present in one or both eyes. The difference of sphere between both eyes was less 1.50D. The difference of astigmatism between both eyes was less 1.00D. All astigmatism was calculated by the absolute value. By analyzing age, sex, astigmatism type, diopter of cylinder and diopter of sphere with Logistic regression, two mathematical models were established. Then the diagnostic efficacy of the model was assessed using the ROC curve.
RESULTS: The model 1 included 4 parameters(sex, astigmatism type, diopter of cylinder and diopter of sphere). The model 2 included 5 parameters(the 4 parameters of the model 1 adding age). Using Logistic regression, the diopter of cylinder had an influence on the diagnosis of meridional amblyopia in two models. In model 2, age was another influencing factor on the diagnosis of meridional amblyopia. The model 1 area under ROC curve(AUC)was 0.64, and the model 2 was 0.74. The area of model 2 was greater than the model 1. There was statistical difference in the AUC of two models(P<0.05).
CONCLUSION: Age might be an influential factor on the diagnosis of meridional amblyopia using Logistic regression and ROC curve.
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