临床医学科研设计统计分析技巧

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1、临床医学科研设计&统计分析技巧中日友好医院李光伟考考你下述研究水平如何？非常好比较好比较差，可修改无可救药例1。胰岛素抵抗抑或胰岛ß细胞缺陷是2型糖尿病的始动因素?---糖尿病一级亲研究IGTNGTN2938NSAGE4846NSBMI24.1+3.023.6+3.3NSWHR0.880.85NSAIR53.5+282.6+1.70.01ᇫI30/ᇫG3010.5+1.712.6+1.8NSHOMA_IR7266NSCONCLUSIONandYOUROPINION胰岛ß细胞缺陷是2型糖尿病的始动因素与国外文献结果一致Next:WhatisyoursuggestiontoT2DMpre

2、ventionandmanagement?Noneedtoimproveinsulinsensitivity?ToimproveinsulinsecretioninordertopreventT2DMinIGTsubjects?例2。不同糖代谢状态微量白蛋白尿发生的危险因素研究NGT(n=112)IGT(n=205)T2DM(n=356)M/F41/7169/136167/189Age51.8±9.958±9.7*53.9±10.6SBP124±19138±18*133±19*DBP81±1286±11*84±10*BMI25.6±3.228±3.3*27±3.8*FBG5.2±0.6

3、6.1±0.6*8.9±2.4*BG27.8±1.39.3±1.8*16.7±5.5*FINS11.5±6.414.5±9.3*16.3±5.4*INS256.3±43.5129±112*45±30*例2。不同糖代谢状态微量白蛋白尿发生的危险因素研究NGT(n=112)IGT(n=205)T2DM(n=356)TG1.48±0.771.56±0.791.97±0.62*TC5.4±1.05.8±1.0*5.6±1.0*HDL-C1.5±0.31.35±0.3*1.2±0.36*SMOKE13.7%17%24.4%*WINE18.8%17%22.4%*DMHIS19%19%35%*UALB

4、(Y,N)4.5%9.8%*18.5%*UALB(mg/24h)5.189.37*18.5*例2.糖耐量异常组微量白蛋白尿发生的危险因素（线性回归）ßpDBP0.358<0.001PBG0.19<0.001HDL-0.23<0.001TG0.20<0.001SMOKE0.228<0.001例2.糖耐量异常组微量白蛋白尿发生的危险因素（LOGIST回归）OR95%CIHT2.111.29-2.91PG2H1.741.21-1.78HDL-C0.530.34-0.87例2.新诊DM组微量白蛋白尿发生的危险因素rpAGEO.1450.006SMOKE0.1590.003HT0.1780.0

5、1BMI0.1210.02SBP0.30<0.0001DBP0.31<0.0001TC0.080.11TG0.294<0.0001HDL-C-0.25<0.0001FBG0.21<0.0001FINS0.35<0.0001例2.新诊DM组微量白蛋白尿发生的危险因素（线性回归）ßpAGE0.0450.337sex0.0480.034smoke0.1270.005DMHIS0.0860.053BMI0.0110.816TC0.0820.07TG0.19<0.0001HDLC-0.1460.001FINS0.354<0.0001FBG0.285<0.0001SBP0.266<0.0001例2

6、.新诊DM组微量白蛋白尿发生的危险因素（LOGIST回归）OR95%CIHT2.011.09-2.91FINS1.651.54-1.80FBG0.2291.21-1.56HDL-C0.420.24-0.67SMOKE1.571.19-1.88例3。糖尿病大血管及微血管病变危险因素研究560例住院病人(心梗,脑梗…)观察指标:AgeSexBMISBPDBPFPGPG2HFINSINS2HHOMA-IRHOMA-ISTCTGHDLLDLApoA1ApoBUAERDurationofDM统计分析非正态分布变量对数转化后分析PearsonSpearmanCorrelationTtestLogi

7、sticregressionResults糖尿病大血管病变:正相关:SBPDurationAgeMaleFINSINS2HHoma-IRHoma-ISLDLUAERDBPBMIFPGPG2HTCTGApoA1ApoB负相关:IAIHDLFemaleLogisticRegression大血管病变(yes,no):危险因素Age2.04（p0.01）HT3.33（p0.0001）(SBPDBP)HINS2.042(p0.004)(FIN