CRP、SAA结合尿常规检测在小儿急性阑尾炎中的诊断价值  

Diagnostic value of CRP and SAA combined with routine urine test in pediatric acute appendicitis

作　　者：梁婷玉 王士然 LIANG Ting-yu;WANG Shi-ran(Yanzhou District People's Hospital,Jining 272100,China)

机构地区：[1]济宁市兖州区人民医院,272100

出　　处：《中国现代药物应用》2025年第7期71-74,共4页Chinese Journal of Modern Drug Application

摘　　要：目的研究小儿急性阑尾炎临床诊断中C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)结合尿常规检测的诊断价值。方法选择60例疑似急性阑尾炎患儿为观察组,同时选取60例同期健康儿童设为对照组。对两组均行CRP、SAA、尿常规检测。以综合诊断为确诊依据,记录观察组患儿诊断结果;比较两组CRP、SAA、白细胞计数、红细胞计数、尿蛋白水平;比较观察组采用不同检查方法的阳性检出率以及诊断效能(灵敏度、特异度、阳性预测值、阴性预测值、诊断符合率)。结果观察组经综合诊断确诊为小儿急性阑尾炎48例,占比80.00%。观察组CRP(14.74±3.85)mg/L、SAA(48.21±10.13)mg/L、白细胞计数(16.45±1.45)×10^(9)/L、红细胞计数(6.75±0.05)×10^(9)/L、尿蛋白(0.27±0.05)g/24 h均高于对照组的(4.11±2.81)mg/L、(8.54±1.07)mg/L、(2.14±0.56)×10^(9)/L、(2.08±0.76)×10^(9)/L、(0.10±0.06)g/24 h,有明显差异(P<0.05)。单一CRP、SAA检查及尿常规检查、联合检查的阳性检出率分别为75.00%、76.67%、81.67%、80.00%。观察组采用不同检查方法的阳性检出率比较无明显差异(P<0.05)。联合检查诊断效能(灵敏度97.92%、特异度91.67%、阳性预测值97.92%、阴性预测值91.67%、诊断符合率96.67%)均高于尿常规检查(灵敏度87.50%、特异度41.67%、阳性预测值85.71%、阴性预测值45.45%、诊断符合率78.33%)、SAA检查(灵敏度83.33%、特异度50.00%、阳性预测值86.96%、阴性预测值42.86%、诊断符合率76.67%)、CRP检查(灵敏度79.17%、特异度41.67%、阳性预测值84.44%、阴性预测值33.33%、诊断符合率71.67%),有明显差异(P<0.05)。结论对急性阑尾炎患儿采取CRP、SAA结合尿常规联合检查诊断效能较佳,有利于患儿疾病诊断,值得推广应用。Objective To study the diagnostic value of C-reactive protein(CRP)and serum amyloid A(SAA)combined with routine urine test in pediatric acute appendicitis.Methods 60 children with suspected acute appendicitis were selected as the observation group,and 60 healthy children were selected as the control group.CRP,SAA and urine routine tests were performed in both groups.The diagnostic results in the observation group were recorded based on comprehensive diagnosis;the levels of CRP,SAA,white blood cell count,red blood cell count and urinary protein were compared between the two groups;the positive detection rate and diagnostic efficiency(diagnostic sensitivity,specificity,positive predictive value,negative predictive value and diagnostic coincidence)of the two test methods in the observation group were compared.Results In the observation group,48 cases of acute appendicitis were confirmed by comprehensive diagnosis,accounting for 80.00%.The observation group had CRP of(14.74±3.85)mg/L,SAA of(48.21±10.13)mg/L,white blood cell count of(16.45±1.45)×10^(9)/L,red blood cell count of(6.75±0.05)×10^(9)/L,and urinary protein of(0.27±0.05)g/24 h,which were higher than(4.11±2.81)mg/L,(8.54±1.07)mg/L,(2.14±0.56)×10^(9)/L,(2.08±0.76)×10^(9)/L,and(0.10±0.06)g/24 h in the control group,and there were significant differences(P<0.05).The positive detection rates of single CRP,SAA,routine urine test and combined tests were 75.00%,76.67%,81.67%and 80.00%,respectively.There was no significant difference in the positive detection rate of different test methods in the observation group(P>0.05).The diagnostic efficiency of combined tests(sensitivity 97.92%,specificity 91.67%,positive predictive value 97.92%,negative predictive value 91.67%,diagnostic coincidence rate 96.67%)were higher than those of routine urine test(sensitivity 87.50%,specificity 41.67%,positive predictive value 85.71%,negative predictive value 45.45%,diagnostic coincidence rate 78.33%),SAA test(sensitivity 83.33%,specificity 50.00%,positive predictive valu

关 键 词：小儿急性阑尾炎 C反应蛋白 血清淀粉样蛋白A 尿常规 诊断价值 

分 类 号：R726.5[医药卫生—儿科]