肝素结合蛋白检测在复杂性阑尾炎术前诊断及预后评估中的价值  

Value of heparin-binding protein detection in the preoperative diagnosis and prognosis evaluation of complicated appendicitis

作　　者：蔡义进 古浩 徐恬 王达丰 石英佐 金鑫 Cai Yijin;Gu Hao;Xu Tian;Wang Dafeng;Shi Yingzuo;Jin Xin(Department of General Surgery,Affiliated Children's Hospital of Jiangnan University(Wuxi Children's Hospital),Wuxi 214023,China;Wuxi Medical Center,Nanjing Medical University,Wuxi 214023,China;School of Environment Engineering,Wuxi University,Wuxi 214105,China)

机构地区：[1]江南大学附属儿童医院(无锡市儿童医院)普外科,无锡214023 [2]南京医科大学无锡医学中心,无锡214023 [3]无锡学院环境工程学院,无锡214105

出　　处：《中华小儿外科杂志》2025年第2期145-149,共5页Chinese Journal of Pediatric Surgery

基　　金：国家自然科学基金青年科学基金项目(82101339)。

摘　　要：目的探究肝素结合蛋白检测在小儿复杂性阑尾炎术前诊断及预后评估中的应用价值。方法选取2021年1月至2023年1月无锡市儿童医院普外科收治的急性阑尾炎患儿262例的临床资料,其中男157例,女105例。所有患儿均经手术探查及术后病理诊断明确,其中复杂性阑尾炎组165例(化脓性82例,坏疽性83例)和单纯性阑尾炎组97例。检测两组患儿术前肝素结合蛋白(heparin-binding protein,HBP)、白细胞(white blood cells,WBC)、中性粒细胞(neutrophils,NE)、C反应蛋白(C-reactive protein,CRP)数值,对比HBP与其他指标在术前诊断中的敏感度、特异度等效能指标,绘制受试者操作特征曲线(receiver operating characteristic curve,ROC)。通过logistic回归分析筛选可协助术前诊断复杂性阑尾炎的指标。结果复杂性阑尾炎组患儿的HBP水平高于单纯性阑尾炎组[(121.92±89.85)比(31.13±31.11),P<0.001]。ROC曲线分析显示的曲线下面积(area under the curve,AUC),术前HBP(0.87)高于WBC(0.85)、CRP(0.82),仅次于NE(0.88),且术前HBP+WBC+NE+CRP联合指标AUC值表现优异(0.94)。多因素logistic回归显示HBP是小儿复杂性阑尾炎的独立危险因素。在预后评估方面,术后HBP水平与患儿恢复情况密切相关。AUC值方面,HBP(0.93)高于WBC(0.87)、NE(0.87)、CRP(0.90),对小儿复杂性阑尾炎预后类型产生显著性影响。结论HBP检测在小儿复杂性阑尾炎术前诊断中具有较高的诊断效能,联合常规检验指标可提高诊断准确性。同时,HBP水平可用于评估小儿复杂性阑尾炎的预后情况。ObjectiveTo explore the application value of heparin-binding protein(HBP)detection in the preoperative diagnosis and prognosis evaluation of complicated appendicitis in children.MethodsClinical data of 262 children with acute appendicitis admitted to the General Surgery Department of Wuxi Children's Hospital from January 2021 to January 2023 were collected,including 157 boys and 105 girls.Diagnosis was comfirmed by surgical exploration and postoperative pathology,including 165 cases in the complicated appendicitis group(82 cases of suppurative and 83 cases of gangrenous)and 97 cases in the simple appendicitis group.Preoperative levels of HBP,white blood cell count(WBC),neutrophil count(NE),and C-reactive protein(CRP)were detected.The sensitivity and specificity of HBP versus other indicators in preoperative diagnosis were calculated by the receiver operating characteristic(ROC)curve.Logistic regression analysis was performed to identify preoperative diagnostic markers of complicated appendicitis.ResultsHBP level of children in the complicated appendicitis group was significantly higher than that in the simple appendicitis group(121.92±89.85 vs 31.13±31.11,P<0.001).ROC curve showed that the area under the curve(AUC)of preoperative HBP(0.87)was higher than that of WBC(0.85)and CRP(0.82),secondary only to NE(0.88).The AUC of the combined preoperative HBP+WBC+NE+CRP performed excellently(0.94).Multivariate logistic regression showed that HBP was an independent risk factor for pediatric complicated appendicitis.The postoperative HBP level was closely related to the prognosis of pediatric complicated appendicitis.The AUC for HBP(0.93)was significantly higher than that of WBC(0.87),NE(0.87),and CRP(0.90).Postoperative HBP level had a significant impact on the prognosis of pediatric complicated appendicitis.ConclusionsHBP detection has a high diagnostic efficacy in the preoperative diagnosis of pediatric complicated appendicitis,and its combination with routine test indicators can improve diagnostic accuracy.At the sam

关 键 词：阑尾炎 诊断 预后 肝素结合蛋白 

分 类 号：R726.5[医药卫生—儿科]