摘要
目的初步探讨医院版卒中后失语患者抑郁问卷（Stroke Aphasic Depression QuestionnaiTe—Hospital version，SADQ—H）诊断卒中后抑郁的截断值。方法运用接受者操作特征（receiver operating characteristic，ROC）曲线法，以17项汉密尔顿抑郁评定量表（17-item Hamilton Depression RatingScale,HAMD·17）总分〉7分、贝克抑郁问卷（Beck Depression Inventory，BDI）-13总分〉4分作为抑郁评定截断值，通过HAMD．17（8～17分为轻度抑郁；18～24分为中度抑郁；〉24分为重度抑郁）初步探讨SADQ—H评价卒中后失语患者抑郁分级标准。结果以HAMD-17为标准时，ROC曲线下面积（areaun dercurve，Auc）为0．909[95％可信区间（confidence interval，C10．814～1．005]，选取19．50分为诊断截断值时，SADQ—H诊断抑郁的敏感性为82．6％，特异性为91．7％，阳性预测值为87．0％，阴性预测值为83．3％，K系数为0．77。以BDI-13为标准时，ROCAUC为0．916（95％C10．824～1．008），选取18．50分为诊断截断值时，SADQ—H诊断抑郁的敏感性为80．0％，特异性为90．O％，阳性预测值84．O％，阴性预测值90．O％，K系数为0．68。SADQ—H评价卒中后失语患者轻、中、重度抑郁的分级标准分别为19分、22分和26分。结论SADQ—H截断值为19分时，对评价抑郁具有较高的敏感性、特异性、阳性预测值和阴性预测值；19分、22分和26分可作为中文版SADQ—H评价卒中后失语患者抑郁情绪的分级诊断标准。
Objective To preliminarily investigate the cutoff value of Stroke Aphasic Depression Questionnaire Hospital Version （SADQ-H） in the diagnosis of post-stroke depres- sion. Methods Using receiver operating characteristic （ROC） curves, the total scores of 17-item Hamilton Depression Rating Scale （HAMD-17） ffeater than 7 points and Beck Depression Inventory （BDI-13） ffeater than 4 points were taken as the cutoff values for the assessment of depression. SADQ-H for the assessment of the depression classification standard in patients with post-stroke aphasia was investigated preliminarily by HAMD-17 （8-17 were mild depres- sion; 18-24 were moderate depression, and 〉24 was severe depression）. Results When HAMD- 17 was used as a standard, ROC area under curve （AUC） was 0. 909 （95% confidence interval [CI] 0.814-1.005）. When 19.50 was used as a cutoff value, the sensitivity, specificity, positive predictive value, negative predictive value, and K coefficient of SADQ-H were 82. 6%,91.7%, 87. 0%, 83.3%, and 0. 77, respectively. When BDI-13 was used as a standard, ROC AUC was 0. 916 （95% CI O. 824-1. 008）. When choosing 18.50 as a cutoff value of diagnosis, the sensitivity, specificity, positive predictive value, negative predictive value, and K coefficient of SADQ-H were 80. 0%, 90. 0%, 84. 0%, 90. 0%, and 0. 68, respectively. The classification standards of SADQ-H for the assessment of depression in patients with post-stroke aphasia were 19, 22 and 26 points. Conclusions When the cutoff value of SADQ-H was 19 points, it had higher sensitivity, specificity, positive predictive value and negative predictive value for the assessment of depression; 19, 22 and 26 points could be used as the classification diagnostic standard of SADQ-H in the assessment of depression in patients with post-stroke aphasia.
出处
《国际脑血管病杂志》
北大核心
2011年第5期376-380,共5页
International Journal of Cerebrovascular Diseases
关键词
精神病状态评定量表
抑郁
卒中
失语
Psychiatric status rating scales
Depression
Stroke
Aphasia
