指甲肌酐ROC曲线下面积对急慢性肾衰竭的鉴别诊断

目的：寻找指甲肌酐（NCr）鉴别急慢性肾衰竭的诊断界值。方法：应用ROC曲线的方法评价NCr作为鉴别诊断急慢性肾衰竭指标的界值及其优劣。结果：于急慢性肾衰竭时NCr个体分布的重叠,选取各截断点下判定值的不同,其灵敏度、特异率发生变化,并使得ROC曲线下的面积不同。本研究所取5个截断点下曲线面积为78.9,NCr取值84.9处为曲线最凸点。结论：ROC曲线的面积在0.7-0.9之间有一定的准确性;以NCr测值84.9作为急慢性肾衰竭NCr的鉴别诊断界值有一定的临床价值。

Assessment of receiver operating characteristic curve on diagnostic value of nail creatinine in acute and chronic renal failure

Objective:To search for diagnostic critical value of nail creatinine (NCr) for acute renal failure (ARF) and chronic renal failure (CRF).Methods:Using receiver operating characteristic (ROC) curve method,we analyzed the diagnostic index for ARF and CRF——diagnostic critical value of NCr.Results:Because of individual distributing overlap of the NCr in ARF and CRF and because of the different determinate value for each selected cut-off point,the sensitivity (Se) and specificity (Sp) might vary,there would be differences in area under the ROC curve.The ROC curve area was 78.9 under the 5 cut-off point,and at peak point of the ROC curve the NCr was 84.9.Conclusions:Because ROC curve method combines Se and Sp to estimate the diagnostic critical value of disease index and determine the veracity by the area under the curve,this method has the practical value for clinical diagnosis when ROC curve area is 0.7-0.9 and NCr was 84.9.