中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2014年
9期
563-565
,共3页
C-反应蛋白%白细胞计数%中性粒细胞比例%小儿急性阑尾炎%手术
C-反應蛋白%白細胞計數%中性粒細胞比例%小兒急性闌尾炎%手術
C-반응단백%백세포계수%중성립세포비례%소인급성란미염%수술
C-reactive protein%White blood count%Neutrophil percentage%Acute appendicitis in children%Surgery
目的 探讨C-反应蛋白(CRP)对小儿急性阑尾炎病理类型的判别意义及对手术时机的指导作用.方法 选择我院2010年1月至2014年2月行阑尾切除术并同时检测了白细胞、中性粒细胞比例和CRP的患儿206例,根据术后病理类型分为坏疽性阑尾炎组(53例)和非坏疽性阑尾炎组(153例),将206例患儿的年龄、性别、白细胞计数、中性粒细胞比例及CRP水平等指标进行Logistic回归分析及ROC分析并绘制ROC曲线.结果 坏疽性阑尾炎组和非坏疽性阑尾炎组患儿的白细胞计数、中性粒细胞比例及CRP水平差异均有统计学意义(P均＜0.05);Logistic回归分析结果显示CRP水平是判断小儿坏疽性阑尾炎的危险因素(P =0.000,OR=1.071);ROC曲线显示CRP对判断小儿坏疽性阑尾炎的作用优于中性粒细胞比例和白细胞计数(曲线下面积分别为0.931、0.659、0.599),其最佳诊断临界值为44.4 mg/L,敏感度75.5％,特异性93.5％.结论 CRP水平有助于判别小儿急性阑尾炎的病理类型,可以作为选择是否手术的一个参考指标.
目的 探討C-反應蛋白(CRP)對小兒急性闌尾炎病理類型的判彆意義及對手術時機的指導作用.方法 選擇我院2010年1月至2014年2月行闌尾切除術併同時檢測瞭白細胞、中性粒細胞比例和CRP的患兒206例,根據術後病理類型分為壞疽性闌尾炎組(53例)和非壞疽性闌尾炎組(153例),將206例患兒的年齡、性彆、白細胞計數、中性粒細胞比例及CRP水平等指標進行Logistic迴歸分析及ROC分析併繪製ROC麯線.結果 壞疽性闌尾炎組和非壞疽性闌尾炎組患兒的白細胞計數、中性粒細胞比例及CRP水平差異均有統計學意義(P均＜0.05);Logistic迴歸分析結果顯示CRP水平是判斷小兒壞疽性闌尾炎的危險因素(P =0.000,OR=1.071);ROC麯線顯示CRP對判斷小兒壞疽性闌尾炎的作用優于中性粒細胞比例和白細胞計數(麯線下麵積分彆為0.931、0.659、0.599),其最佳診斷臨界值為44.4 mg/L,敏感度75.5％,特異性93.5％.結論 CRP水平有助于判彆小兒急性闌尾炎的病理類型,可以作為選擇是否手術的一箇參攷指標.
목적 탐토C-반응단백(CRP)대소인급성란미염병리류형적판별의의급대수술시궤적지도작용.방법 선택아원2010년1월지2014년2월행란미절제술병동시검측료백세포、중성립세포비례화CRP적환인206례,근거술후병리류형분위배저성란미염조(53례)화비배저성란미염조(153례),장206례환인적년령、성별、백세포계수、중성립세포비례급CRP수평등지표진행Logistic회귀분석급ROC분석병회제ROC곡선.결과 배저성란미염조화비배저성란미염조환인적백세포계수、중성립세포비례급CRP수평차이균유통계학의의(P균＜0.05);Logistic회귀분석결과현시CRP수평시판단소인배저성란미염적위험인소(P =0.000,OR=1.071);ROC곡선현시CRP대판단소인배저성란미염적작용우우중성립세포비례화백세포계수(곡선하면적분별위0.931、0.659、0.599),기최가진단림계치위44.4 mg/L,민감도75.5％,특이성93.5％.결론 CRP수평유조우판별소인급성란미염적병리류형,가이작위선택시부수술적일개삼고지표.
Objective To clarify diagnostic value of C-reactive protein (CRP) in the pathological types of acute appendicitis in children and the role of CRP as a surgical indication marker for appendicitis.Methods Two hundred and six patients who underwent appendectomies and had pathologically confirmed appendicitis were reviewed between January 2010 and February 2014,and they were divided into gangrenous appendicitis group(n =53) and non-gangrenous appendicitis group(n =153) by postoperative pathological type.The correlation between preoperative clinical factors and the actual histological severity,and identify surgical indication markers were assessed by multivariate analysis and ROC analysis.Results There were significant differences in white blood count(WBC),neutrophils percentage and CRP level between gangrenous appendicitis group and non-gangrenous appendicitis group(P ＜ 0.05).Multivariate analysis showed that the level of CRP should be a risk factor for judging gangrenous appendicitis.It showed that the role of CRP in judging gangrenous appendicitis was superior to the proportion of neutrophils and WBC in the ROC curve.The ROC curve showed that the area under the ROC curve for the CRP level,neutrophils percentage and WBC was 0.931,0.659 and 0.599 respectively,and the optimal cut off value of CRP for surgical indication for classifying cases was around 44.4 mg/L,and the sensitivity was 75.5 ％,specificity was 93.5 ％.Conclusion The level of CRP is useful in identifying the pathological types of acute appendicitis in children,and can be considered to be a surgical indication marker for acute appendicitis in children.
