免疫抑制酸性蛋白与中性粒细胞/淋巴细胞比值及血清C-反应蛋白检测对急性阑尾炎诊断的意义

目的探讨急性阑尾炎(AA)患者血清免疫抑制酸性蛋白(IAP)与外周血中性粒细胞/淋巴比值(N/L比值)以及血清C-反应蛋白(CRP)变化及对诊断的意义。方法检测AA患者术前血清IAP、CRP水平和外周WBC,并计算N/L。结果AA患者血清IAP水平均较对照组明显升高(P<0.01),坏疽或穿孔性组较急性单纯性与化脓性阑尾炎组明显升高(P<0.01)。N/L比值明显高于对照组;病情越严重,N/L比值越高。AA患者CRP水平高于对照组(P<0.01),坏疽或穿孔性组CRP水平较急性单纯性与化脓性阑尾炎组又有明显升高(P<0.01)。IAP、CRP与N/L比值联合检测对白细胞计数正常的AA诊断有重要意义,对这部分AA预测的准确率达100%(42/42)。结论IAP、N/L比值及CRP能比较准确地反映AA的病情,三者联合检测能进一步提高对AA诊断的准确性。

The clinical significance of examining serum immunosuppressive acidic protein, C-reactive protein as well as the ratio of neutrophil vs lymphocyte in patients with acute appendicitis

Objective To study the changes and their clinical significance of serum immunosuppressive acidic protein(IAP),C-reactive protein(CRP) and the ratio of neutrophil vs lymphocyte(N/L ratio) in patients with acute appendicitis.Methods The preoperative serum IAP and CRP levels,leukocyte count as well as N/L ratio were determined in 151 patients with acute appendicitis.Results The serum IAP levels in patients were significantly higher than those of healthy people(normal control group)(P<0.01),and the serum IAP levels in patients with gangrenous or perforated appendicitis were significantly higher than those with simple or suppurative appendicitis(P<0.01).The N/L ratios in patients were significantly higher than those of the control group(P<0.01).The N/L ratio increased when the patients' condition worsened.There was a significant difference in CRP levels between the patients with acute appendicitis and the control group(P<0.01),and the serum CRP levels in patients with gangrenous or perforated appendicitis were significantly higher than those with simple or suppurative appendicitis(P<0.01).The combined examination of IAP,CRP and N/L ratio may improve the accuracy of diagnosis in patients with normal leukocyte count,and the accuracy of diagnosis in current study was 100%(42/42).Conclusion The changes of preoperative IAP and CRP levels as well as N/L ratio may reflect the patients' conditions more accurately,suggesting this triplex examination can improve the accuracy of diagnosis.