红细胞分布宽度和降钙素原对儿童急性阑尾炎诊断价值  

Values of Red Blood Cell Distribution Width and Procalcitonin in Diagnosis of Children with Acute Appendicitis

作　　者：马奔[1] 李春[1] 邱乐[2] MA Ben;LI Chun;QIU Le(Department of Pediatric Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230000,China;Department of Burn and Wound Repair Surgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学第一附属医院小儿外科,合肥230000 [2]安徽医科大学第一附属医院烧伤与创面修复外科,合肥230000

出　　处：《临床误诊误治》2021年第11期97-101,共5页Clinical Misdiagnosis & Mistherapy

基　　金：国家自然科学基金面上项目(81671877)。

摘　　要：目的探讨红细胞分布宽度(RDW)和降钙素原(PCT)对儿童急性阑尾炎诊断价值。方法选取2020年2月—2021年2月收治的儿童急性阑尾炎268例作为阑尾炎组,同期健康体检儿童120例作为对照组。根据病理类型不同将儿童急性阑尾炎268例分为单纯组(单纯性急性阑尾炎,121例)、化脓组(化脓性急性阑尾炎,105例)和坏疽或穿孔组(坏疽或穿孔性急性阑尾炎,42例)3组。比较阑尾炎组和对照组及不同病理类型儿童急性阑尾炎3组临床资料,探讨RDW、PCT及二者联合对儿童急性阑尾炎及化脓性和坏疽或穿孔性儿童急性阑尾炎诊断价值,分析急性阑尾炎患儿RDW、PCT与Alvarado评分相关性。结果阑尾炎组RDW和PCT高于对照组;Alvarado评分和RDW、PCT单纯组低于化脓组和坏疽或穿孔组,化脓组低于坏疽或穿孔组(P<0.05或P<0.01)。受试者工作特征曲线分析结果显示,RDW和PCT二者联合较单一对儿童急性阑尾炎及化脓性和坏疽或穿孔性儿童急性阑尾炎诊断价值的曲线下面积大。Pearson相关性分析结果显示,急性阑尾炎患儿RDW、PCT与Alvarado评分呈正相关(P<0.01)。结论儿童急性阑尾炎RDW和PCT升高,且病情越重升高越明显,RDW和PCT二者联合对儿童急性阑尾炎及其不同病理类型诊断价值较高。Objective To explore values of red blood cell distribution width(RDW)and procalcitonin(PCT)in diagnosis of children with acute appendicitis.Methods A total of 268 children with acute appendicitis admitted between February 2020 and February 2021 were selected as appendicitis group,and other 120 healthy children who had undergone physical examinations at the same period were selected as control group.According to different pathological types,the 268 children with acute appendicitis were divided into simple subgroup(simple acute appendicitis,n=121),suppurative subgroup(suppurative acute appendicitis,n=105)and gangrene or perforation subgroup(gangrene or perforated acute appendicitis,n=42).Clinical data was compared between appendicitis and control groups and among 3 subgroups,and values of RDW,PCT and combined detection of the two indexes in diagnosis of children with acute appendicitis,purulent and gangrene or perforated acute appendicitis were explored.Correlations between RDW and PCT with Alvarado score were analyzed in children with acute appendicitis.Results RDW and PCT levels in appendicitis group were significantly higher than those in control group;values of Alvarado score,RDW and PCT in simple subgroup were significantly lower than those in suppurative and gangrene or perforation subgroups,and the values in suppurative subgroup were significantly lower than those in gangrene or perforation subgroup(P<0.05 or P<0.01).Results of receiver operating characteristic(ROC)curve analysis showed that the area under the ROC curve by combined detection of RDW and PCT was the largest than those by each index detection in differential diagnosis of children with acute appendicitis,purulent and gangrene or perforated acute appendicitis.Results of Pearson correlation analysis showed that RDW and PCT were positively correlated with Alvarado score in children with acute appendicitis(P<0.01).Conclusion RDW and PCT levels increase in children with acute appendicitis,and the more serious the disease is,the more obvious the incre

关 键 词：阑尾炎 儿童 红细胞分布宽度 降钙素原 诊断 病理类型 

分 类 号：R726.56[医药卫生—儿科]