检测血清降钙素原和白介素-6在儿童急性阑尾炎的预测价值  

Predictive value of serum procalcitonin and interleukin-6 on acute appendicitis in children

作　　者：柳宏[1] 潘新民[1] 连树华[1] 

机构地区：[1]甘肃省人民医院小儿外科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2016年第2期72-75,共4页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的探讨降钙素原(PCT)和白介素-6(IL-6)对儿童阑尾炎严重程度的预测价值。方法回顾性78例急性阑尾炎患儿的临床资料,根据术中所见和术后病理结果,将息儿分为单纯性阑尾炎组(34例)和阑尾炎合并腹膜炎组(44例)。PCT胶乳增强免疫比浊法测定血清PCT含量,化学发光法测定血清IL-6含量,分析PCT和IL-6鉴别两组不同类型阑尾炎的规律及其临床意义。结果阑尾炎合并腹膜炎组血清PCT和IL-6水平均高于单纯性阑尾炎组(P<0.05),两组患儿血清PCT与IL-6呈正相关(r=0.562,P<0.05)。当PCT以0.23 ng/mL作为临界值时,诊断腹膜炎的灵敏度为93%,特异度为78%,阳性预测值为76%,阴性预测值为87%;当IL-6以35 pg/mL作为临界值时,诊断腹膜炎的灵敏度为96%,特异度为77%,阳性预测值为71%,阴性预测值为96%。结论在儿童急性阑尾炎发病过程中,血清PCT和IL-6的水平均能反映病情的严重程度,PCT的预测价值优于IL-6。Objective To investigate the predictive value of the procalcitonin （PCT） and interleukin-6 （IL-6） on the severity of children appendicitis. Methods A retrospective analysis of clinical data of 78 cases of children with acute appendicitis was committed. According to the intraoperative findings and postoperative pathological results, children were divided into two groups, namely simple appendicitis group （34 cases） and appendicitis with peritonitis group （44 cases）. PCT content was tested by latex-enhanced immune turbidimetry, and IL-6 level was determined by chemiluminescence, and then analyze the regularities and clinical significance of PCT and IL-6 levels in identifying two different types of appendicitis. Results The serum PCT and IL-6 levels in appendicitis combined peritonitis group were significantly higher than those in simple appendicitis group （P 〈 0.05）, serum PCT and 1L-6 levels were positively correlated in both group （r=0.562, P 〈 0.05）. When the PCT came to 0.23 ng/mL as the critical value, the sensitivity in the diagnosis of peritonitis was 93%, specificity for 78%, positive predictive value for 76%, negative predictive value for 87%. When IL-6 came to 35 pg / mL as the critical value, IL-6 sensitivity in the diagnosis of peritonitis was 96%, specificity for 77%, positive predictive value for 71%, negative predictive value for 96%. Conclusion In the course of acute appendicitis in children, serum PCT and IL-6 levels can reflect the severity of the disease, the predictive value of PCT is superior to IL-6.

关 键 词：阑尾炎 腹膜炎 降钙素原 白介素-6 预测 儿童 

分 类 号：R726[医药卫生—儿科]