目的 比较S.T.O.N.E.肾结石评分与Guy肾结石分级对经皮肾镜取石术(percutaneous nephroscope lithoipsy, PCNL)结石清除率预测的准确性。方法 选择2015-01至2017-12在西安交通大学第二附属医院接受PCNL的患者146例,术前分别进行S.T.O.N.E.评分和Guy分级。术后统计结石清除率,分别计算S.T.O.N.E.评分和Guy分级的ROC曲线下面积,对比两种方法预测的准确性。结果 结石清除率为73.97%。S.T.O.N.E.肾结石评分预测PCNL术后结石清除率的准确性为74.8%,最佳阈值为8.5分,灵敏度为73.7%,特异度为71.3%;Guy分级预测PCNL术后结石清除率的准确性为71.5%,最佳阈值为2.5级,灵敏度为71.1%,特异度为64.8%。两种方法的ROC曲线下面积分别为0.748和0.715,无统计学差异。结论 S.T.O.N.E.评分与Guy分级均具有中等水平预测能力,均可用来评估PCNL术后结石清除率,两个方法的预测能力未见统计学差别。
Abstract
Objective To compare the accuracy of S.T.O.N.E. renal calculus score and Guy’s renal calculus grading in predicting stone clearance rate after PCNL. Methods One hundred and forty six patients treated in the Second Affiliated Hospital of Xi'an Jiaotong University between January 2015 and December 2017 were assessed with S.T.O.N.E. score and Guy’s grading respectively before PCNL. The postoperative stone clearance rate was calculated. The area under the ROC curve of S.T.O.N.E. score and Guy’s grading was calculated respectively, and the accuracy of the two methods was compared. Results The stone clearance rate was 73.9%. The accuracy of S.T.O.N.E. renal calculus score in predicting stone clearance rate after PCNL was 74.8%. The best threshold was 8.5 points. The sensitivity was 73.7%, and specificity was 71.3%. The accuracy of Guy’s grading in predicting stone clearance rate after PCNL was 71.5%. The best threshold was 2.5, sensitivity was 71.1%, and specificity was 64.8%. The area under the ROC curve of the two methods was 0.748 vs 0.715, so there was no statistically significant difference (chi2(1)=0.41,P=0.52). Conclusions Both S.T.O.N.E. score and Guy’s grading have an average predictive power, which could be used to predict stone clearance rate after PCNL. There is no significant difference in predictive power between the two methods.
关键词
肾结石 /
准确性 /
S.T.O.N.E.评分系统 /
Guy’s分级 /
经皮肾镜碎石取石术
Key words
nephrolithiasis /
accuracy /
S.T.O.N.E. scoring system /
Guy’s grading /
percutaneous nephrolithotomy lithotripsy
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