白细胞计数、C反应蛋白及降钙素原联合检测对儿童穿孔性阑尾炎的预测价值  

Predictive value of the combined detection of white blood cell count,C-reactive protein,and procalcitonin in children with perforating appendicitis

作　　者：孙丽云 许银洁 崔钊 SUN Liyun;XU Yinjie;CUI Zhao(Changchun University of Chinese Medicine,Jilin Province,Changchun 130117,China;Children’s Medical Center of Jilin Province,Jilin Province,Changchun 130000,China)

机构地区：[1]长春中医药大学,吉林长春130117 [2]吉林省儿童医疗中心,吉林长春130000

出　　处：《妇儿健康导刊》2025年第1期111-114,127,共5页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：目的探讨白细胞计数(WBC)、C反应蛋白(CRP)及降钙素原(PCT)联合检测对儿童穿孔性阑尾炎的预测价值。方法回顾性分析2017年1月至2023年4月吉林省儿童医疗中心收治的427例阑尾炎患儿的临床资料,其中穿孔组113例,非穿孔组314例。采用单因素、多因素分析法分析穿孔性阑尾炎的危险因素,采用受试者工作特征曲线获取最佳截断值并评估各方法的预测效能。结果单因素分析显示,WBC、CRP、PCT可作为阑尾穿孔的影响因素(P<0.05)。多因素分析显示,WBC、CRP、PCT均可作为阑尾穿孔的独立危险因素(OR>1,P<0.05)。WBC、CRP、PCT三项联合预测效能优于两项及单独预测,灵敏度为0.894,特异度为0.764,阳性预测值为74.64%,阴性预测值为81.94%。WBC、CRP、PCT最佳截断值分别为17.42×10^(9)/L、34.09 mg/L、0.355μg/L。结论WBC、CRP、PCT联合检测可以准确地预测儿童穿孔性阑尾炎的发生,能够作为术前早期评估儿童阑尾炎严重程度的方法。Objective To explore the predictive value of the combined detection of white blood cell count(WBC),C-reactive protein(CRP),and procalcitonin(PCT)in children with perforating appendicitis.Methods A retrospective analysis of clinical data of 427 children with appendicitis admitted to Children’s Medical Center of Jilin Province from January 2017 to April 2023 was performed,including 113 cases in the perforated group and 314 cases in the nonperforated group.Univariate and multivariate analysis were used to analyze the risk factors of perforating appendicitis,and the receiver operator characteristic curve was used to obtain the best cut-off value and evaluate the predictive efficacy of each method.Results Univariate analysis showed that WBC,CRP,and PCT could be used as influencing factors for appendiceal perforation(P<0.05).Multivariate analysis showed that WBC,CRP,and PCT could be used as independent risk factors for appendiceal perforation(OR>1,P<0.05).The combined predictive performance of WBC,CRP,and PCT was better than that of two or their individual predictions,with a sensitivity of 0.894,specificity of 0.764,positive predictive value of 74.64%,and negative predictive value of 81.94%.The optimal cut-off values for WBC,CRP,and PCT were 17.42×10^(9)/L,34.09 mg/L,and 0.355μg/L,respectively.Conclusion The combined detection of WBC,CRP,and PCT can accurately predict the occurrence of perforating appendicitis and can be used as a method for early preoperative evaluation of the severity of appendicitis in children.

关 键 词：白细胞计数 C反应蛋白 降钙素原 儿童穿孔性阑尾炎 

分 类 号：R725.7[医药卫生—儿科]