儿童复杂性阑尾炎C反应蛋白/白蛋白、Toll样受体4、降钙素原、可溶性细胞间黏附因子1水平变化及诊断价值  

Changes and diagnostic value of C-reactive protein/albumin,Toll-like receptor 4,procalcitonin,and soluble intercellular adhesion molecule 1 levels in children with complex appendicitis

作　　者：张培 戚士芹 未德成 ZHANG Pei;QI Shiqin;WEI Decheng(The Second Department of General Surgery,Anhui Children’s Hospital,Anhui Province,Hefei 230000,China)

机构地区：[1]安徽省儿童医院普外二科,安徽合肥230000

出　　处：《中国医药导报》2022年第11期99-102,共4页China Medical Herald

摘　　要：目的探究儿童复杂性阑尾炎C反应蛋白/白蛋白(CRP/ALB)、Toll样受体4(TLR-4)、降钙素原(PCT)、可溶性细胞间黏附因子1(sICAM-1)水平变化及诊断价值。方法选择2018年6月至2021年6月安徽省儿童医院接受手术治疗的86例急性阑尾炎患儿,按照病理类型分为单纯性阑尾炎组(34例)和复杂性阑尾炎组(52例)。比较两组CRP/ALB、PCT、TLR-4、sICAM-1水平,对影响复杂性阑尾炎的各指标进行logistic回归分析,绘制受试者操作特征(ROC)曲线,并计算曲线下面积(AUC)及灵敏度、特异度。结果复杂性阑尾炎组CRP/ALB、TLR-4、PCT、sICAM-1水平高于单纯性阑尾炎组,差异有统计学意义(P<0.05)。logistic回归分析结果显示,CRP/AlB、TLR-4、PCT、sICAM-1水平是复杂性阑尾炎的危险因素(OR>1,P<0.05)。四项联合检测预测复杂性阑尾炎的AUC高于CRP/ALB、TLR-4、PCT、sICAM-1单独检测(P<0.05);四项联合检测的灵敏度、特异度高于CRP/ALB、TLR-4、PCT、sICAM-1单独检测。结论复杂性阑尾炎发生时,CRP/ALb、TLR-4、PCT、sICAM-1水平异常升高,均是影响复杂性阑尾炎的危险因素,在预测复杂性阑尾炎上均具有一定的预测价值,四项指标联合检测对于复杂性阑尾炎具有较好的诊断和病理分型价值。Objective To research the changes and diagnostic value of C-reactive protein/albumin(CRP/ALB),Toll-like receptor 4(TLR-4),procalcitonin(PCT),and soluble intercellular adhesion molecule 1(sICAM-1)levels in children with complex appendicitis.Methods A total of 86 children with acute appendicitis who underwent surgical treatment in Anhui Children’s Hospital from June 2018 to June 2021 were selected,and they were divided into simple appendicitis group(34 cases)and complex appendicitis group(52 cases)according to the pathological type.The levels of CRP/ALB,PCT,TLR-4,and sICAM-1 in two groups were compared,the indexes affecting complex appendicitis were analyzed by logistic regression,the receiver operating characteristic(ROC)curve of each index was drawn,and the area under curve(AUC),sensitivity,and specificity were calculated.Results The levels of CRP/ALB,TLR-4,PCT,and sICAM-1 in complex appendicitis group were higher than those in simple appendicitis group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that CRP/ALB,TLR-4,PCT,and sICAM-1 were the risk factors of complex appendicitis(OR>1,P<0.05).The AUC of four combined test in predicting complex appendicitis was higher than that of CRP/ALB,TLR-4,PCT,and sICAM-1 alone(P<0.05);the sensitivity and specificity of four combined test were higher than that of CRP/ALb,TLR-4,PCT,and sICAM-1 alone.Conclusion When complex appendicitis occurs,the levels of CRP/ALB,TLR-4,PCT,and sICAM-1 in children are abnormally elevated,which are risk factors affecting complex appendicitis and have certain predictive value in prediction of appendicitis.The combined detection of the four indicators has good diagnostic and pathological value for complex appendicitis.

关 键 词：儿童复杂性阑尾炎 C反应蛋白/白蛋白 TOLL样受体4 降钙素原 可溶性细胞间黏附因子1 

分 类 号：R726.5[医药卫生—儿科]