基于渐进式截尾数据的两组慢性肾病患者生存曲线的比较

Shrawan Kumar
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摘要

慢性肾脏疾病(CKD)是指肾脏功能的进行性丧失。随着糖尿病、高血压和老年人口的增加,CKD各阶段的患病率呈上升趋势。在印度,这正在成为一个流行病的问题。目的:比较基于性别、糖尿病、高血压不同疾病危重期CKD患者的生存功能。患者与方法:采用2006年3月至2016年10月117例CKD患者的回顾性资料。本研究采用log-rank、Gehan-Wilcoxon、Tarone-Ware、Peto-Peto、modified Peto-Peto以及属于Fleming-Harrington检验家族的不同(p, q)值的检验来检验两种生存函数在不同条件下差异的统计学意义。采用参数检验比较两组患者的生存时间分布。结果:Kaplan-Meier法和生存比较检验显示,在分组变量性别的基础上,女性和男性两组的生存经历没有差异。然而,在模拟研究中,当我们增加样本量时,观察到它对女性的影响大于男性,特别是在CKD的3期患者中。两组基于糖尿病和高血压的CKD患者的生存功能有显著差异。结论:在真实数据和模拟研究的基础上,两组CKD患者以糖尿病和高血压为分组变量的生存经历存在显著差异。分组变量性别作为一个重要因素,只有在模拟研究中产生大样本时才显现出来
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On the comparison of survival curves of two groups of chronic kidney disease patients based on progressively censored data
Introduction: Chronic kidney disease (CKD) is the progressive loss of kidney function. Prevalence of every stage of CKD is rising over the period with increasing number of diabetic, hypertensive and elderly population. It is becoming a problem of epidemic proportions in India. Objectives: Comparison of the survival function of CKD patients with different disease stages criticality grouped on the basis of gender, diabetes and hypertension. Patients and Methods: The retrospective data of 117 patients suffering from CKD during the period March 2006 to October 2016 is used. In the present study, log-rank, Gehan-Wilcoxon, Tarone-Ware, Peto-Peto, modified Peto-Peto and tests belonging to Fleming-Harrington test family with different (p, q) values are applied to test the statistical significance of the difference between two survival functions under different conditions. The parametric test has also been applied to compare the survival time distribution of two groups. Results: Kaplan-Meier method and survival comparison tests suggest no difference between survival experiences of the two groups namely female and male on the basis of grouping variable gender. However, in simulation study as we increase the sample size it is observed that it affects more women than men especially in stage 3 of CKD patients. The survival functions of two groups of CKD patients based on diabetes and hypertension differ significantly. Conclusion: The survival experiences of two groups of CKD patients based on the grouping variables diabetes and hypertension differ significantly on the basis of real data and simulation study. The grouping variable gender as a significant factor becomes evident only when large samples are generated under simulation study
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