简体中文版老年男性症状量表的信度、效度及适用性分析

目的研究简体中文版老年男性症状量表(Chinese version of the Aging Males'Symptoms scale,CN-AMS)应用于国内中老年男性迟发性性腺功能减退时的信度、效度及实际使用效果。方法受访人群包括33岁以下青年男性27人,40岁以上中老年男性81人。要求所有受访志愿者完成AMS量表填写及间隔4周后的复填,以验证CN-AMS量表的有效性。为了验证中老年受访者是否存在雄激素缺乏,在每次填写量表时抽取空腹晨血,检测血清总睾酮(total serum testosterone,TT)、性激素结合球蛋白(sex hormone binding globulin,SHBG)水平,计算出血清游离睾酮(calculated free testosterone,cFT)水平。统计学上采用α信度系数法(Cronbach’s alpha)和重测信度法(test-retest stability)验证CN-AMS量表的信度。重测信度法采用Pearson相关性(Pearson's correlation)分析重测相关系数。采用单项与总和相关效度分析(Pearson's correlation)验证CN-AMS量表的逻辑效度。结果 27位青年男性完成了量表填写及4周后的复填。81位中老年男性中有57人接受了重复抽血,其中46位完成量表复填。CN-AMS量表的Cronbach’sα信度系数和Pearson's correlation系数在青年组为0.86和0.91,老龄组是0.91和0.83,两组人群合并后的数值则是0.94和0.91,显示出很好的效度和内在结构一致性。以cFT 225 pmol/L作为诊断迟发性性腺功能减退(late onset hypogonadism in males,LOH)的血清学阈值。量表的敏感度为81%,特异性为44%。结论研究证明CN-AMS在中国中老年男性LOH筛查中具有良好的适用性,但其特异性并不高,不适合单独用于LOH的诊断。

Analysis of reliability, validity and applicability of the simplified Chinese version of the Aging Males/ Symptoms scale

Objective To validate and confirm the reliability and applicability of the simplified Chinese version of the Aging Males＇ Symptoms scale （ CN - AMS） in the older Chinese men. Methods Collected 27 men younger than 33 years old and 81 men 40 years old or older agreed to accept a self - administered questionnaire using the CN - AMS. The reliability was taken as internal consistency reliability （Cronbach＇ s alpha） as well as test - retest stability. The old men＇s blood were sampled for analyzing the sensitivity and specificity of CN - AMS in screening late-onset hypogonadism（LOH）. The total testosterone and sex hormone binding globulin analyzed and calculated free testosterone（cFT） was taken as the serum standard for diagnosis of LOH. Results All 27 young men filled the CN- AMS twice with a 4 - week interval. The 81 old men were asked to fill in the questionnaires and their total serum testosterone and sex hormone binding globulin were analyzed. With a 4 - week interval 57 of the 81 old men＇ s blood samples were collected and 46 of the 57 old men filled the CN - AMS again. The Cronbach＇ s alpha coefficient and the 4 -week retest reliability were 0. 86 and O. 91 for young men group~ 0. 91 and 0. 83 for aging men group. The test-retest analysis showed good reliability and internal consistency for the CN -AMS. The value of cFT（225 pmol/L） was a cut off point for the serum standard to diagnose LOH. The sensitivity and specificity for CN - AMS was 79% and 44%, respectively. Conclusion This questionnaire can be has better confident for the screening of LOH in aging Chinese males but it has no enough specificity for the diagnosis of LOH.