目的 验证自制的藏区成人大骨节病功能评分（function score for adult Tibetans with Kashin-Beck disease，FSAT-KBD）量表用于评价阿坝地区藏族成人KBD患者的日常生活和劳动功能状态的信度和效度。方法 用FSAT-KBD量表于2010年9~10月对阿坝洲壤塘县352例成年KBD患者进行现场调查。用Cronbach α 系数检验FSAT-KBD的内部一致性信度，用主成分因子分析检验结构效度，用Spearman秩相关检验维度相关性效度。将患者分别按年龄、患病时间和受累关节数分组，通过比较各亚组之间量表得分是否存在差异来检验区分效度。用Spearman秩相关分析FSAT-KBD得分与美国医学结局研究简短健康调查量表（medical outcomes study short form health survey, SF-12）和疼痛视觉模拟量表（visual analogue scale，VAS）得分的相关性检验汇聚效度。用t检验比较KBD患者和当地正常居民的量表得分差异检验FSAT-KBD的区分效度。结果 该量表的应答率为96.0%，完成率为100%，平均完成时间为（3.2±1.6） min。Cronbach α 系数为0.945。提取了2个公因子，解释了量表总变异的72.8%，各条目在相应主因子上的载荷均>0.5，与理论假设一致。各条目与总分的相关性均大于0.6。量表得分具有年龄越大、患病时间越长、受累关节数越多的患者得分越低的趋势。FSAT-KBD得分与SF-12和VAS之间有较好的相关性。KBD患者量表得分低于年龄配伍的当地正常居民（ P<0.001）。结论 FSAT-KBD可用于评价阿坝藏区成人KBD患者的功能状况，具有较好的信度和效度。
英文摘要:
Gastrointestinal tumor could be aggressive and life threaten if it was not be diagnosed and treated at early stage. Digestive endoscopy plays a very important role in the early diagnosis and treatment of gastrointestinal tumor, and shows rapid evolution with novel technologies in the past years, such as endoscopic ultrasonography, magnifying endoscopy, electronic staining endoscopy, endoscopic confocal laser microscopy. Nowaday it becomes feasible to learn more about the endoscopic manifestation in early stage GI tumor. Besides, several new endoscopic surgical techniques, such as endoscopic submucosal dissection (ESD), endoscopicsubmucosal tunnel dissection (ESTD), submucosal tunneling endoscopic resection （STER），has been applied in clinical treatment of early stage GI tumor with curative effect. However, there are some new problems emerged, such as how to determine the depth of the lesion, how to avoid or reduce the incidence of postoperative complications, and how to standardize the pathological classification and the treatment of positive margin, which need multidisciplinary solution with the efforts from endoscopist, clinician and pathologist. With the deep insight on, molecular pathogenesis of GI tumor, new technologies combinding endoscopy, imaging and pathological measures, will promote more GI tumor early diagnosed and effectively treated, thus improve the survival and prognosis of GI tumor patients.
