摘要
目的探讨临床体测参数与肾脏移动度的相关性及其对肾下垂的预测价值。方法测量2021年度338名空军招飞学生肾脏移动度,以及身高、体质量、胸围、腹围、血压等数据,并计算体质量指数(BMI)及体表面积(body surface area,BSA)。按照招飞医学选拔肾下垂诊断标准分为肾下垂组和对照组,比较2组间各参数差异,采用Spearman等级相关性分析研究肾脏移动度与临床体测参数间的关系,二分类Logistic回归分析寻找肾脏移动度独立影响参数,最后建立工作特征(receiver operating characteristic,ROC)曲线预测模型,得出最佳胸围、腹围、BMI截断值。结果①肾下垂组学生腹围、胸围、BMI均低于对照组,差异有统计学意义(Z=2.656、3.377、3.020,P=0.008、0.001、0.003)。肾下垂组学生的身高高于对照组,差异有统计学意义(Z=2.215,P=0.027);②338名招飞学生的体质量、腹围、胸围、BMI和BSA的临床体测参数与肾脏移动度均存在负相关(r=-0.203、-0.236、-0.232、-0.244、-0.182,P<0.001、<0.001、<0.001、<0.001、=0.01);③二分类Logistic回归分析,结果显示BMI、胸围、腹围为肾下垂发生的独立影响因素(P<0.05);④本研究以肾下垂临床诊断标准为参照,绘制ROC曲线,评价胸围、腹围及BMI诊断招飞学生肾下垂的效能。胸围诊断肾下垂的临界值、灵敏度、特异度、曲线下面积(area under curve,AUC)分别为87.25、45.0%、81.2%、0.659;腹围诊断肾下垂的临界值、灵敏度、特异度、AUC分别为77.25、44.3%、83.0%、0.592;BMI诊断肾下垂的临界值、灵敏度、特异度、AUC分别为21.61、39.6%、88.0%、0.674。结论胸围、腹围及BMI是肾下垂独立预测指标,由此构建的预测模型对肾下垂有较好的预警效果。建议招飞体检中BMI<21.61 kg/m^(2)、胸围<87.25 cm及腹围低于77.25 cm的学生为肾下垂重点筛查对象。
Objective To investigate the correlations between clinical body measurement parameters and renal mobility and study their value for prediction of nephroptosis.Methods The kidney mobility,height,weight,chest circumference,abdominal circumference and blood pressure of 338 Air Force flight candidates in 2021 were measured.The BMI and body surface area(BSA)were calculated and divided into the nephroptosis group and the control group according to the diagnostic criteria for nephroptosis during medical selection of flight candidates.The parameters were compared between the two groups.Spearman rank correlation analysis was conducted to study the relationships between renal mobility and clinical physical measurement parameters,while logistic regression analysis was performed to identify the parameters independently influenced by renal mobility.Finally,a receiver operating characteristic(ROC)prediction model was established to derive the optimal chest circumference,abdominal circumference,and BMI cut-off values.Results①The abdominal circumference,chest circumference,and BMI of students in the nephroptosis group were lower than those in the control group,and the differences were statistically significant(Z=2.656,3.377,3.020,P=0.008,0.001,0.003).Students in the nephroptosis group were taller than those of the control group,with statistically significant difference(Z=2.215,P=0.027).②Clinical physical parameters of weight,abdominal circumference,chest circumference,BMI and BSA were negatively correlated with renal mobility in the 338 students(r=-0.203,-0.236,-0.232,-0.244,-0.182,P<0.001,<0.001,<0.001,<0.001,=0.01);③One-way logistic regression analysis showed that BMI,chest circumference,and abdominal circumference were independent influencing factors for the occurrence of nephroptosis(P<0.05).④In this study,ROC curves were drawn according to the clinical diagnostic criteria to evaluate the role of chest circumference,abdominal circumference and BMI in diagnosing nephroptosis among these students.The critical value,sensitivity,specificity,and AUC of chest circumference for the diagnosis of nephroptosis were 87.25,45.0%,81.2%,and 0.659,respectively,compared with 77.25,44.3%,83.0%and 0.592 respectively for abdominal circumference,and 21.61,39.6%,88.0%,and 0.674 respectively for BMI.Conclusion Chest circumference,abdominal circumference and BMI are independent predictors of nephroptosis,and the prediction model thus constructed is capable of early warning of nephroptosis.It is recommended that students with BMI below 21.61 kg/m^(2),chest circumference below 87.25 cm and abdominal circumference below 77.25 cm during the medical examination for flight recruitment be the key screening targets for nephroptosis.
作者
龚凤玲
刘涵生
李利
赵国政
孙斌
孙安
刘淑萍
GONG Fengling;LIU Hansheng;LI Li;ZHAO Guozheng;SUN Bin;SUN An;LIU Shuping(Graduate School,Heibei North University,Zhangjiakou Hebei 075000,China;不详)
出处
《空军航空医学》
2023年第2期128-131,共4页
AVIATION MEDICINE OF AIR FORCE
基金
全军后勤科研重点项目(BKJ20B043)
空军军医大学效能提升项目(2020ZTB08)
空军特色医学中心科技助推项目(2022ZTYB04)。
关键词
超声
体格检查
人员选用
肾脏移动度
预测指标
ultrasound
physical examination
personnel selection
kidney mobility
prediction indicator
