炎症细胞因子对急性阑尾炎的预测价值分析  

Predictive value of inflammatory cytokines for acute appendicitis

作　　者：张思东[1] 戴邦武 万里明[1] 高学祥[2] ZHANG Si-dong;DAI Bang-wu;WAN Li-ming;GAO Xue-xiang(General Surgery,Hefei Third People’s Hospital,Hefei,Anhui 230000,China;Department of Clinical Laboratory,Hefei Third People’s Hospital,Hefei,Anhui230000,China)

机构地区：[1]合肥市第三人民医院普外科,230000 [2]合肥市第三人民医院检验科,230000

出　　处：《现代消化及介入诊疗》2019年第10期1129-1132,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的 旨在探究炎症细胞因子对早期疑似急性阑尾炎的鉴别及预测价值。方法 选取2016年12月至2018年12月到合肥市第三人民医院就诊的80例疑似急性阑尾炎患者作为研究对象,采集外周血检测降钙素原、WBC、CRP及中性粒细胞表达水平,评价其对急性阑尾炎的临床诊断价值。结果 急性阑尾炎患者血浆PCT、CRP、中性粒细胞、WBC水平分别显著高于其非急性阑尾炎者和健康者,差异具有统计学意义(P<0.05)。超声检查诊断急性阑尾炎的敏感性为85.19%,特异性为94.34%。CT检查诊断急性阑尾炎的敏感性为96.3%,特异性为92.45%。PCT、CRP、中性粒细胞和WBC诊断急性阑尾炎的ROC曲线下面积分别为0.788(95%CI:0.678-0.897)、0.760(95%CI:0.647-0.872)、0.812(95%CI:0.700-0.925)、0.806(95%CI:0.687-0.925);而联合检测诊断急性阑尾炎的ROC曲线下面积为0.877(95%CI:0.766-0.988),其敏感性(81.5%)、特异性(94.3%)均优于单项检测。结论 降钙素原、中性粒细胞、C反应蛋白或白细胞计数单项检测对临床上疑似急性阑尾炎患者的评估没有足够高的敏感性和特异性,联合上述炎症因子和辅助影像学检查将有利于阑尾炎的准确诊断。Objective To explore identifying and predicting value of inflammatory cytokines for early suspected acute appendicitis. Methods During the period from December2016 to December2018, 80 patients with suspected acute appendicitis who were treated in the hospital for emergency treatment were enrolled. Peripheral blood was collected to detect expression levels of procalcitonin,WBC,CRP and neutrophil. Their clinical diagnostic value for acute appendicitis was evaluated. Results The levels of plasma PCT,CRP,neutrophils and WBC in patients with acute appendicitis were significantly higher than those in non-acute appendicitis patients and healthy people ( P <0.05). The sensitivity and sensitivity of ultrasound examination and CT examination were (85.19%,94.34%) and (96.3%,92.45%),respectively. The areas under ROC curves of PCT,CRP,neutrophils and WBC were 0.788 (95% CI: 0.678-0.897), 0.760 (95% CI: 0.647-0.872),0.812 (95% CI: 0.700-0.925) and 0.806 (95% CI: 0.687-0.925),respectively. AUC,sensitivity and specificity of combined detection were 0.877 (95% CI: 0.766- 0.988),81.5% and of 94.3%,better than those of single detection. Conclusion The sensitivity and specificity of single detection with procalcitonin,neutrophils,C-reactive protein or white blood cell count are not sufficient for clinical evaluation on patients with suspected acute appendicitis. Conclusionof the above inflammatory factors for assisting imaging examination is conducive to accurate diagnosis of appendicitis.

关 键 词：炎症细胞 临床诊断 急性阑尾炎 预测价值 

分 类 号：R656.8[医药卫生—外科学] R574[医药卫生—临床医学]