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目的应用网络数据库进行数据挖掘,探讨建立用3～5个关键的症状、体征组合来初步快速判断脑膜炎的社区辅助诊断方法。方法用中国知网数据库收集近4年符合纳入标准的161例脑膜炎患者和161例非脑膜炎患者完整的病例资料,以脑膜炎患者的临床症状、体征为自变量,采用单因素方法进行变量筛选后对有统计学意义的变量进行多元Logistic回归分析,拟定脑膜炎诊断三联征,以病例诊断为金标准,对研究得出的诊断三联征的诊断效果进行评价。结果应用多元回归方程提取出的脑膜炎初筛三联征是发热、头痛和脑膜刺激征,以其做工具检测脑膜炎的灵敏度是71.4%,特异度是78.9%,阳性预测值是77.2%,阴性预测值是73.4%;与金标准的诊断符合率用调整一致性指标来评价,为75.2%。结论以发热、头痛和脑膜刺激征组合的脑膜炎诊断三联征作为一种简单、方便、快速和有效的方法,可用于基层医疗单位初筛脑膜炎患者,成为鉴别诊断和转诊患者的参考依据。
Objective To apply the network database for data mining and discuss the establishment of a community-based auxiliary diagnosis method for early and rapid diagnosis of meningitis with 3 to 5 key symptoms and signs. Methods The data of 161 cases of meningitis and 161 cases of non-meningitis who met the inclusion criteria in the recent 4 years were collected by using CNKI database. The clinical symptoms and signs of meningitis patients were used as independent variables. Single factor analysis After screening, statistically significant variables were analyzed by multivariate Logistic regression, and the triad of meningitis was developed. The diagnostic value of the triad of diagnosis was evaluated based on the case diagnosis as the gold standard. Results The triad of triad of meningitis extracted by multivariate regression equation was fever, headache and meningeal irritation. Sensitivity for detecting meningitis was 71.4%, specificity was 78.9%, positive predictive value was 77.2%, and negative The predicted value was 73.4%. The coincidence rate with the gold standard was evaluated by adjusting the consistency index to 75.2%. Conclusion The triad of meningitis diagnosis combined with fever, headache and meningeal irritation can be used as a simple, convenient, rapid and effective method for primary screening meningitis patients in primary medical units and become the reference basis for the differential diagnosis and referral of patients .