血清C反应蛋白和降钙素原对小儿急性阑尾炎的诊断价值

 目的 探讨血清C反应蛋白(C-reactive protein,CRP)及降钙素原(procalcitonin,PCT)对小儿急性阑尾炎诊断价值。方法 实验组选取96例武警兵团指挥部医院普外科确诊为急性阑尾炎的小儿患者,对照组选取同一时期来院体检的56名健康儿童,分别检测2组患者血清CRP、PCT、中性粒细胞比例(NEUT%)及白细胞计数(WBC)水平,并对实验组CRP和PCT的特异性、敏感性进行统计分析。结果 实验组血清CRP(27.73±6.77)mg/L、PCT(1.78±0.86)μg/L、NEUT%(80.63±10.35)%及WBC(14.20±3.21)×10⁹/L含量均显著高于对照组的(4.17±1.36 )mg/L、(0.43±0.76)μg/L、 (63.45±7.3)%、(9.07±3.59)×10⁹/L,两组比较差异具有统计学意义 (P<0.01);分型不同的阑尾炎组间血清CRP和PCT水平比较,差异有统计学意义(P<0.05);实验组患者血清CRP诊断敏感性、特异性分别为88.5%、71.9%,PCT的诊断敏感性、特异性分别为85.4%、90.6%,二者敏感性比较差异无统计学意义,但特异性比较差异有统计学意义 (P<0.01)。结论 血清CRP、PCT含量检测对诊断小儿急性阑尾炎有一定的临床价值,尤其是PCT水平对小儿急性阑尾炎诊断有较高的敏感性和特异性,更适合作为判断阑尾炎程度的辅助性诊断指标。

Application of serum CRP and PCT to diagnosis of infantile acute appendicitis

Objective To investigate the clinical applicability of serum CRP and PCT in the diagnosis of infantile acute appendicitis.Methods Ninety-six children diagnosed with acute appendicitis were recruited in the experimental group, while fifty-six healthy children who were subjected to a physical examination at the same time were selected in the control group.The levels of serum CRP, PCT, NEUT% and WBC were detected respectively. The specificityand sensitivity of PCT and CRP in the experimental group were statistically analyzed.Results The levels of serum CRP(27.73±6.77)mg/L,PCT(1.78±0.86)μg/L,NEUT%(80.63±10.35)% and WBC(14.20±3.21)×10⁹/L in the experimental group were significantly higher than those in the control group(4.17±1.36)mg/L,(0.43±0.76)μg/, (63.45±7.3)and(9.07±3.59)×10⁹/L respectively. The levels of serum CRP and PCT were significantly different between different groups of appendicitis(P<0.05). The sensitivity and specificity of CRP were 71.9% and 88.5% respectively, while those of PCT were 85.4% and 90.6% respectively. The difference in sensitivity was of no statistical significance, but the difference in specificity was(P<0.01).Conclusions The detection of serum CRP and PCT levels is of some clinical value in diagnosis of infantile acute appendicitis. As the PCT level has a high sensitivity and specificity, it can serve better as an auxiliary diagnostic indicator for appendicitis.