【作者】 金鑫； 徐浩； 蒋若尧； 邓一文； 李春蕾； 曾昕； 唐国瑶； 华红； 陈谦明；

【Author】 Xin Jin;Hao Xu;Ruoyao Jiang;Yiwen Deng;Chunlei Li;Xin Zeng;Guoyao Tang;Hong Hua;Qianming Chen;State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University;Department of Oral Medicine, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology;Department of Oral Medicine, Peking University School and Hospital of Stomatology;

【机构】 口腔疾病研究国家重点实验室； 国家口腔疾病临床医学研究中心； 国家临床重点专科； 四川大学华西口腔医院口腔黏膜病科； 上海交通大学附属第九人民医院口腔黏膜病科； 北京大学口腔医院口腔黏膜病科；

【摘要】 目的:根据现有OLP评分系统,初步建立一个更加完善的OLP病情严重程度判定的改良评分系统,以便对OLP病情进行客观化精确描述,为治疗方案的选择和调整、疗效评估、临床试验结果标准化提供参考依据。方法:1.回顾和总结现有OLP评分系统的优点和不足,查阅文献,设计改良OLP评分系统。同时结合临床实际,规范使用该评分系统的操作流程。2.依纳入和排除标准收集2017年11月至2018年2月期间在四川大学华西口腔医院口腔黏膜病科、上海交通大学第九人民医院口腔黏膜病科、北京大学口腔医院口腔黏膜病科就诊的OLP患者,在初诊和复诊时对患者进行改良OLP评分系统以及REU评分系统的评估。3.以信度系数Cronbachα为改良OLP评分表内部一致性指标,计算信度;利用两种评估体系与专家评分的斯皮尔曼相关系数(Spearman’srank correlation coefficient, rsp)评价各病情评估体系的效度;利用主观评分和客观评分的斯皮尔曼相关系数评估评分系统各部分间的一致性。结果:1.改良口腔扁平苔藓评分系统的建立改良OLP评分系统主要由两部分组成:客观评分和主观评分。客观评分主要观察口内黏膜的11个部分,医生根据网纹病损的面积大小给予分值(0分=无网纹;1分=网纹面积小于50%;2分=网纹面积大于或等于50%),并分别计算各部位充血及糜烂病损的面积,总分由网纹分值、充血及糜烂面积的数值标准化后加权求得;主观评分由疼痛评分和生活质量相关量表评分组成。除评分者评分外,还纳入了专家评分。2.改良口腔扁平苔藓评分系统的应用初探改良OLP评分表,相较"金标准"专家评分,有良好的标准效度。且与REU评分表的效度相近。改良OLP评分表内部一致性较高。改良OLP评分表与数值评分法疼痛评分、生活事件评分及口腔健康影响程度量表评分相互独立。OLP评分系统需要客观评分及主观评分结合起来反映患者病情。结论:初步建立的改良OLP评分系统具有良好的效度和效度,且客观评分与主观评分相结合,优于现有的OLP评分系统,可较为全面地反映患者病情,具有进一步临床推广使用的价值。更多还原

【Abstract】 Objectives:1. To analyze present OLP scoring system. 2. To make an improved OLP scoring system. 3. To verify the validity, reliability and responsibility of the improved scoring system. Methods:1.Search for literature to find frequently-used scoring systems and analyze their advantages and disadvantages. 2. Make an improved OLP scoring system combining those relatively good scoring systems and add what is missing in existing systems. Make a protocol to perform the improved OLP scoring system. 3. Apply the improved OLP scoring system to patients. Fill the forms of the system when patients come to visit. Results: 1. An improved OLP scoring system is formulated, which includes subjective scores and objective scores.Subjective scores are tested by measuring the area of erythema and ulcer. Objective scores consist of pain score and quality-of-life score. A protocol to perform the improved system is made. 2. Comparing to physician’s global assessment, the improved scoring system has a good criterion validity. Its internal consistency and responsibility to change is relatively low. Subjective scores and objective scores are independent from each other. Conclusion: Existing scoring systems of OLP has some drawbacks. The improved OLP scoring system has good criteria validity and reflect patients’ state of illness in different dimensions.更多还原