PTX-3联合PCT检测在小儿急性阑尾炎诊断及病理分型中的价值  

Value of PTX-3 combined with PCT in the diagnosis and pathological classification of acute appendicitis in children

作　　者：张玮[1] 梁峰[2] 张敏 孙红[1] 张雪峰[1] 雷杰[1] 李庆丰[1] ZHANG Wei;LIANG Feng;ZHANG Min;SUN Hong;ZHANG Xuefeng;LEI Jie;LI Qingfeng(Department of Pediatric Surgery,the First Affiliated Hospital of Hebei North College,Zhangjiakou,Hebei 075000,China;Department of Hepatobiliary Surgery,the First Affiliated Hospital of Hebei North College,Zhangjiakou,Hebei 075000,China;Department of Clinical Laboratory,the First Affiliated Hospital of Hebei North College,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院小儿外科,河北张家口075000 [2]河北北方学院附属第一医院肝胆外科,河北张家口075000 [3]河北北方学院附属第一医院检验科,河北张家口075000

出　　处：《国际检验医学杂志》2020年第21期2615-2619,共5页International Journal of Laboratory Medicine

基　　金：河北省张家口市2019年度市级科技计划自筹经费项目(1921057D)。

摘　　要：目的探讨正五聚体蛋白-3(PTX-3)联合血清降钙素原(PCT)检测对小儿急性阑尾炎诊断及病理分型的价值。方法选取该院2018年5月至2019年12月收治的163例疑似小儿急性阑尾炎患儿作为A组,另选取同期108例健康儿童作为B组,检测两组研究对象血清PTX-3、PCT水平并进行比较。A组均实施腹腔镜下探查术明确急性阑尾炎是否发生,对急性阑尾炎发生者实施腹腔镜下切除术,并实施病理分型检测,比较急性阑尾炎发生者和未发生者血清PTX-3、PCT水平,评价二者联合检测诊断小儿急性阑尾炎的价值;比较不同病理分型急性阑尾炎患儿术前、术后3 d、术后7 d血清PTX-3、PCT水平;分析术前血清PTX-3、PCT联合检测评价急性阑尾炎病理分型的效能。结果入选者中小儿急性阑尾炎占79.14%,A组血清PTX-3、PCT水平均高于B组,A组急性阑尾炎发生者血清PTX-3、PCT水平均高于未发生者,差异均有统计学意义(P<0.05);血清PTX-3和PCT联合检测诊断小儿急性阑尾炎的特异度、准确度分别为94.12%、95.09%,均高于单项检测,灵敏度与单项检测相近;129例急性阑尾炎患儿的病理分型为单纯型23例,化脓型60例,穿孔坏疽型31例,阑尾周围脓肿型15例。4组患儿血清PTX-3、PCT水平随着术后时间延长均逐渐下降,且同一时刻单纯组<化脓组<穿孔坏疽组<阑尾周围脓肿组;血清PTX-3和PCT联合检测评价单纯型、化脓型、穿孔坏疽型、阑尾周围脓肿型急性阑尾炎的受试者工作特征曲线下面积分别为0.889、0.871、0.841、0.807,均高于单项指标检测。结论疑似小儿急性阑尾炎患儿血清PTX-3、PCT水平偏高,且急性阑尾炎发生者均高于未发生者,二者联合检测对该病有良好的诊断及病理分型价值。Objective To explore the value of pentraxin-3(PTX-3)combined with serum procalcitonin(PCT)in the diagnosis and pathological classification of acute appendicitis in children.Methods A total of 163 suspected children with acute appendicitis received by the hospital from May 2018 to December 2019 were taken as group A.Another 108 healthy children were taken as group B.Serum PTX-3 and PCT levels were measured in both groups,and the differences between them were compared.Laparoscopic resection was performed and pathological classification was performed in the group A.The serum PTX-3 and PCT levels were compared between the patients with and without acute appendicitis.The value of combined diagnosis of acute appendicitis in children was evaluated.The serum PTX-3 and PCT levels of children with different pathological types of acute appendicitis were compared before operation,3 days after operation and 7 days after operation.The preoperative serum PTX-3 and PCT levels to evaluate the efficacy of pathological classification of acute appendicitis was analyzed.Results The proportion of children with acute appendicitis was 79.14%.The levels of PTX-3 and PCT in group A were higher than those in group B,and the levels of PTX-3 and PCT in patients with acute appendicitis were higher than those in patients without acute appendicitis,and the differences were statistically significant(P<0.05).The specificity and accuracy of PTX-3 combined with PCT in the diagnosis of acute appendicitis in children were 94.12%and 95.09%respectively,which were higher than those of single detection,and the sensitivity was similar to that of single detection.There were 23 simple type,60 suppurative type,31 gangrene type and 15 periappendiceal abscess type in 129 children.The serum PTX-3 and PCT levels of the four groups decreased with time,at the same time,PTX-4 level showed as simple group<pyogenic group<perforation gangrene group<periappendiceal abscess group.The area under receiver operating characteristic curve of acute appendicitis of simple type

关 键 词：正五聚体蛋白-3 降钙素原 急性阑尾炎 诊断 病理分型 

分 类 号：R726.5[医药卫生—儿科]