HMGB1、sICAM-1、NLR、CRP联合CT检测在儿童急性阑尾炎中的临床价值分析  

Clinical value of combined detection of HMGB1,sICAM-1,NLR,CRP and CT in pediatric acute appendicitis

作　　者：王珂珂 李志彬[1] 经豪 Wang Ke-ke;Li Zhi-bin;Jing Hao(Department of Pediatric Surgery,Shangqiu First People's Hospital,Shangqiu 476005,Henan,China)

机构地区：[1]商丘市第一人民医院小儿外科,河南商丘476005

出　　处：《四川生理科学杂志》2025年第2期413-416,共4页

摘　　要：目的:探讨高迁移率蛋白B1(High mobility group box 1 protein,HMGB1)、可溶性细胞间粘附分子-1(Soluble intercellular adhesion molecule-1,sICAM-1)、中性粒细胞淋巴细胞比值(Neutrophil-to-lymphocyte ratio,NLR)、C-反应蛋白(c-reactive protein,CRP)联合电子计算机断层扫描(Computed tomography,CT)检测在儿童急性阑尾炎中的临床价值。方法:回顾性选取2021年1月至2023年9月我院收治的262例急性阑尾炎患儿作为研究对象,并记为病例组,随机选取同期进行健康体检的儿童271例作为对照组。分析病例组和对照组血清HMGB1、sICAM-1、NLR、CRP水平、CT影像学特征,统计CT诊断急性阑尾炎患儿准确率,绘制受试者工作特征曲线(Receiver operating characteristic,ROC)分析HMGB1、sICAM-1、NLR、CRP水平、CT单一及联合检测对小儿急性阑尾炎的诊断价值。结果:与对照组进行比较,病例组血清HMGB1、sICAM-1、NLR、CRP水平均明显更高(P<0.05)。与对照组进行比较,病例组阑尾增粗、阑尾钙化影、低密度团块影、脂肪条纹征、腰大肌征、彗星尾征、箭头征的检出患儿占比均更高(P<0.05)。262例急性阑尾炎患儿,CT诊断出231例,诊断准确率88.17%(231/262)。ROC曲线分析结果显示,HMGB1、sICAM-1、NLR、CRP水平、CT联合检测诊断小儿急性阑尾炎的曲线下面积(Area under the curve,AUC)高于五者单一检测(P<0.05)。结论:血清HMGB1、sICAM-1、NLR、CRP水平与急性阑尾炎患儿的发生密切相关,急性阑尾炎患儿的CT影像学特征与健康儿童存在差异,且HMGB1、sICAM-1、NLR、CRP水平、CT联合检测具有较高预测价值,临床可据此尽早进行诊断并给予针对性治疗,以积极改善患儿预后。Objective:To investigate the clinical value of high-mobility protein B1(HMGB 1),soluble intercellular adhesion molecule-1(SICAM-1),neutrophil lymphocyte ratio(NLR),C-reactive protein(CRP)combined with computed tomography(CT)detection in pediatric acute appendicitis.Methods:Retrospectively,262 children with acute appendicitis admitted to our hospital from January 2021 to September 2023 were selected as the study objects and recorded as the case group,and 271 children undergoing physical examination in the same period were randomly selected as the control group.HMGB 1,sICAM-1,NLR,CRP level,CT imaging characteristics of case and control groups,the accuracy of CT diagnosis of acute appendicitis in children was analyzed,and the receiver operating characteristic(ROC)was drawn to analyze the diagnostic value of HMGB 1,sICAM-1,NLR,CRP level,CT single and combination detection of pediatric acute appendicitis.Results:Compared with the control group,the serum HMGB 1,sICAM-1,NLR and CRP in the case group were significant higher(P<0.05).The proportion of children with appendix thickening,appendix calcishadow,low density mass shadow,fatty stripe pattern,lumbar major muscle sign,comet tail sign,and arrow sign in case group was higher than that in control group(P<0.05).In 262 children with acute appendicitis,231 patients were diagnosed by CT,with a diagnostic accuracy of 88.17%(231/262).ROC curve analysis showed that HMGB 1,sICAM-1,NLR,CRP level,and area under the curve(AUC)was higher than those of five single tests(P<0.05).Conclusion:Serum HMGB 1,sICAM-1,NLR,CRP levels are closely related to the occurrence of pediatric acute appendicitis,the CT imaging characteristics of the children with acute appendicitis are different from healthy children,and HMGB 1,sICAM-1,NLR,CRP,and CT combination have high predictive value,clinical diagnosis and targeted treatment to actively improve the prognosis of pediatric acute appendicitis.

关 键 词：急性阑尾炎 高迁移率蛋白B1 可溶性细胞间粘附分子-1 中性粒细胞淋巴细胞比值 C-反应蛋白 电子计算机断层扫描 

分 类 号：R73[医药卫生—肿瘤]