生物标志物对急性扁桃体炎并发症的诊断准确度研究及阈值选择  

Accuracy and threshold selection of biomarkers on complications diagnostic in acute tonsillitis

作　　者：杨甜 郭广威[2] 谭冰 YANG Tian;GUO Guangwei;TAN Bing(Department of Otolaryngology,Jiangxi Health Vocational College,Nanchang,Jiangxi 330052,China;Department of Otolaryngology,Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi 530003,China)

机构地区：[1]江西卫生职业学院五官教研室,南昌330052 [2]广西壮族自治区妇幼保健院耳鼻喉科,南宁530003

出　　处：《重庆医学》2019年第2期241-243,共3页Chongqing medicine

基　　金：江西省教育厅科技计划项目(GJJ161455)

摘　　要：目的探讨急性细菌性扁桃体炎严重并发症的预测因素。方法选择广西壮族自治区妇幼保健院门诊及住院的314例急性扁桃体炎严重并发症患者,使用受试者工作特征曲线(ROC)和Youden检验进行分析。结果咽后脓肿[(256.8±116.6)mg/L]和坏死性筋膜炎患者[(352.3±163.2)mg/L]C反应蛋白(CRP)水平最高(P<0.05)。扁桃体周脓肿和咽后脓肿与链球菌感染相关(P<0.05),而下行性扁桃体周脓肿和咽旁脓肿与厌氧菌感染相关(P<0.05),坏死性筋膜炎则与混合感染相关(P<0.05)。扁桃体周脓肿患者年龄较低(P<0.05)。ROC分析确定了急性细菌性扁桃体炎无并发咽后脓肿的界限值为年龄小于或等于35周岁及CRP≤155.0mg/L,灵敏度和特异度分别为100%及94%。结论年龄大于35周岁联合CRP>155.0mg/L可辅助诊断咽后脓肿和坏死性筋膜炎。Objective To analyse the underlying predisposing factors on complications diagnostic in acute tonsillitis.Methods Acute tonsillitis patients with complications from outpatient service and hospitalization in our hospital were seclected.Data was analyzed by receiver operating curve(ROC)and Youden-test.Results C-reactive protein demonstrated a significant highest level in retropharyngeal abscess(RPA)[(256.8±116.6)mg/L]and necrotizing fasciitis(NF)[(352.3±163.2)mg/L,P<0.05].Peritonsillar abscess(PTA)and RPA were usually caused by streptococcus(P<0.05),PTA and parapharyngeal abscess(PPA)were caused by anaerobic bacteria(P<0.05),and NF were caused by mixed infections(P<0.05).Patients with PTA were younger(P<0.05).ROC-analysis identified cut-offs for age<35 years and CRP<155.0 mg/L to distinguish acute bacterial tonsillitis from RPA with a sensitivity/specificity of 100%/94%.Conclusion Age >35 years old and serum CRP >155.0 mg/L maybe used as diagnostic methods in patients with RPA and NF.

关 键 词：扁桃体炎 筋膜炎 坏死性 扁桃体周脓肿 并发症 

分 类 号：R766.5[医药卫生—耳鼻咽喉科]