血清高迁移率蛋白B1在急性阑尾炎诊断中的意义  

Significance of high mobility groupbox-B1 in diagnosis of acute appendicitis

作　　者：章燕青 沈观樵[2] 金海勇[2] 张奇[2] 陈文虎[3] 沈香娣[3] ZHANG Yan- qing, SHEN Guan - qiao, JIN Hai - yong, ZHANG Qi, CHEN Wen - hu, SHEN Xiang - di(Pingshui Branch, the Second Hospital of Shaoxing, Shaoxing, Zhejiang 312030, Chin)

机构地区：[1]绍兴第二医院平水分院,浙江绍兴312030 [2]绍兴第二医院检验科,浙江绍兴312030 [3]杭州医学院基础医学部,浙江杭州310053

出　　处：《中国卫生检验杂志》2018年第9期1082-1083,1086,共3页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医学创新学科建设计划项目(2015-13)

摘　　要：目的探讨血清高迁移率蛋白B1(HMGB1)水平变化在急性阑尾炎诊断中的价值。方法 132例疑似急性阑尾炎的急腹症患者,包括急性复杂型阑尾炎73例(坏疽性35例、化脓性38例)、急性单纯性阑尾炎34例、非阑尾炎25例,50例健康体检者作对照。收集所有研究对象的WBC计数和血清HMGB1、hs-CRP水平并进行统计学分析。结果 3组患者WBC和血清HMGB1、hs-CRP均明显高于对照组(P<0.05),血清HMGB1和hs-CRP所有急性组均明显高于非阑炎组(P<0.05)、复杂型组明显高于单纯性组(P<0.05)。以4.5 ng/ml为血清HMGB1异常界值,血清HMGB1诊断复杂型阑尾炎的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为87.7%、88.2%、94.1%、76.9%和87.9%。结论血清HMGB1水平可用于炎症反应程度评估和复杂型阑尾炎的诊断。Objective To analyze the value of high mobility groupbox-B1（HMGB1） in the diagnosis of acute appendicitis（AA）. Methods The 132 patients with acute abdomen who had a diagnosis of suspected acute appendicitis were enrolled in this study,including 73 cases of complex AA（35 gangrenous AA and 38 suppurative AA）,34 cases of simple AA patients and25 cases of non-appendicitis patients,and 50 cases of healthy people were collected as controls. The white blood cell（WBC）count,and serum HMGB1 and high sensitive C-reactive protein（hs-CRP） levels were conducted for statistical analysis.Results WBC,HMGB1 and hs-CRP level of all patient groups were much higher than that of control group（P 〈 0. 05）;HMGB1 and hs-CRP levels in two groups of AA patients were much higher than that in non-AA patients（P 〈 0. 05）;HMGB1 and hs-CRP levels in patients with complex AA were much higher than that in patients with simple AA（P 〈 0. 05）.The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of serum HMGB1 in the diagnosis of complex appendicitis were respectively 87. 7%,88. 2%,94. 1%,76. 9%,and 87. 9%,with an abnormal cut-off value of serum HMGB1 of 4. 5 ng/ml. Conclusion Serum HMGB1 levels can be used to assess the extent of inflammatory reactions and the diagnosis of complex appendicitis.

关 键 词：急性阑尾炎 高迁移率蛋白B1 超敏C-反应蛋白 

分 类 号：R656.8[医药卫生—外科学]