中华皮肤科杂志 ›› 2026, Vol. 59 ›› Issue (11): 1099-1105.doi: 10.35541/cjd.20260368

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基于德尔菲法构建神经梅毒疗效评估指标体系研究

杜方智1    张栩1    郑晓丽1    李梦宇1    张瑞丽2    王千秋1   

  1. 1中国医学科学院北京协和医学院，皮肤病医院  中国疾病预防控制中心性病控制中心临床防治室，南京  210042；2南京医科大学第二附属医院皮肤科，南京  210011
  • 收稿日期:2026-07-06 修回日期:2026-09-10 发布日期:2026-11-03
  • 通讯作者: 王千秋；张瑞丽 E-mail:wangqq@ncstdlc.org; reallyvictor@126.com
  • 基金资助:
    云南省科技厅重点研发计划（202403AC100011）；中国医学科学院医学与健康科技创新工程项目（2021-I2M-1-001）

Construction of an evaluation indicator system for therapeutic efficacy in neurosyphilis based on the Delphi method

Du Fangzhi¹, Zhang Xu¹, Zheng Xiaoli¹, Li Mengyu¹, Zhang Ruili², Wang Qianqiu¹   

  1. ¹Department of STD Clinical Management and Intervention, National Center for STD Control, Chinese Center for Disease Control and Prevention, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China; ²Department of Dermatology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
  • Received:2026-07-06 Revised:2026-09-10 Published:2026-11-03
  • Contact: Wang Qianqiu; Zhang Ruili E-mail:wangqq@ncstdlc.org; reallyvictor@126.com
  • Supported by:
    Key Research and Development Program of Yunnan Province Science and Technology Department （202403AC100011）; CAMS Innovation Fund for Medical Sciences （2021-I2M-1-001）

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摘要： 【摘要】 目的 构建科学的神经梅毒疗效评估指标体系。方法 基于系统文献检索与资料提取，初步构建神经梅毒疗效评估指标体系。采用3轮德尔菲法专家函询，由21位专家对拟定指标条目进行修订及重要性评分。逐轮计算专家权威程度与意见协调程度，并据此修订指标。根据后两轮函询中各指标的重要性评分，计算变异系数与指标权重。结果 3轮专家函询的问卷回收率均 > 85%，专家权威系数均 > 0.89，第2轮和第3轮函询肯德尔和谐系数分别为 0.433和0.519，均有统计学意义（P < 0.05），专家意见趋于一致。经过3轮专家函询，最终确立包含3项一级指标、13项二级指标的神经梅毒患者疗效评估指标体系。一级指标为“临床表现”“实验室检测”“辅助检查”；二级指标包含3个首要指标［“脑脊膜型、脑膜血管型、眼、耳梅毒等患者症状是否改善或痊愈”（权重0.224 7）、“脑脊液白细胞计数恢复正常”（权重0.178 9）和“脑脊液非梅毒螺旋体抗体滴度下降2个稀释度及以上”（权重0.1401）］，10个次要指标。结论 本研究基于德尔菲法构建了适用于中国人群的神经梅毒患者疗效评估指标体系，可为临床开展系统化、科学化的疗效评估提供依据。

关键词: 神经梅毒, 治疗结果, 疗效评估, 指标体系, 德尔菲法

Abstract: 【Abstract】 Objective To construct a scientific evaluation indicator system for therapeutic efficacy in neurosyphilis using the Delphi method. Methods A literature review and data extraction were performed to develop a preliminary draft of the evaluation indicator system for therapeutic efficacy in neurosyphilis. In 3 rounds of Delphi expert consultations, 21 experts revised the proposed indicator items and rated their importance. The expert authority coefficient and the degree of consensus were calculated in each round, and the indicators were revised accordingly. Based on the importance scores from the final 2 rounds, the coefficient of variation and the weights for each indicator were determined. Results The response rates across all 3 rounds of consultations exceeded 85%, with expert authority coefficients consistently above 0.89. Kendall′s coefficient of concordance was 0.433 in the second round and 0.519 in the third round （both P < 0.05）, indicating a relatively high degree of consensus. Following 3 rounds of consultations, an evaluation indicator system for therapeutic efficacy in neurosyphilis was ultimately established, including 3 first-level indicators and 13 second-level indicators. The first-level indicators were clinical manifestations, laboratory tests, and auxiliary examinations. The second-level indicators consisted of 3 primary indicators and 10 secondary indicators; the 3 primary indicators were “symptom improvement or recovery in patients with meningeal, meningovascular, ocular, or otic syphilis” （weight: 0.2247）, “normalization of the cerebrospinal fluid white blood cell count” （weight: 0.1789）, and “a decrease of at least 2 dilutions in the cerebrospinal fluid non-treponemal antibody titer” （weight: 0.1401）. Conclusion The evaluation indicator system for therapeutic efficacy in neurosyphilis, which was applicable to the Chinese population, was successfully constructed based on the Delphi method, providing a basis for systematic and scientific efficacy assessment in clinical practice.

Key words: Neurosyphilis, Treatment outcome, Efficacy evaluation, Indicator system, Delphi method

引用本文

杜方智 张栩 郑晓丽 李梦宇 张瑞丽 王千秋. 基于德尔菲法构建神经梅毒疗效评估指标体系研究[J]. 中华皮肤科杂志, 2026,59(11):1099-1105. doi:10.35541/cjd.20260368

Du Fangzhi¹, Zhang Xu¹, Zheng Xiaoli¹, Li Mengyu¹, Zhang Ruili², Wang Qianqiu¹. Construction of an evaluation indicator system for therapeutic efficacy in neurosyphilis based on the Delphi method[J]. Chinese Journal of Dermatology, 2026, 59(11): 1099-1105.doi:10.35541/cjd.20260368