[1]徐永康,云叶,赵永祥,等.血清C反应蛋白、白介素-6和降钙素原对小儿急性复杂性阑尾炎的诊断价值研究[J].临床小儿外科杂志,2021,20(01):60-64.[doi:10.12260/lcxewkzz.2021.01.012]
　Xu Yongkang,Yun Ye,Zhao Yongxiang,et al.Applicable value of serum c-reactive protein,interleukin 6 and procalcitonin in acute complex pediatric appendicitis[J].Journal of Clinical Pediatric Surgery,2021,20(01):60-64.[doi:10.12260/lcxewkzz.2021.01.012]
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血清C反应蛋白、白介素-6和降钙素原对小儿急性复杂性阑尾炎的诊断价值研究

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第20卷 期数: 2021年01期 页码: 60-64 栏目: 论著 出版日期: 2021-01-28
Title:
Applicable value of serum c-reactive protein,interleukin 6 and procalcitonin in acute complex pediatric appendicitis
作者:
徐永康1;  云叶1;  赵永祥1;  姜海山1;  赵俊刚2;  张建国1;  吴向铭1
1. 包头市第四医院小儿外科(内蒙古包头市, 014000);
2. 苏州大学附属儿童医院(江苏省苏州市, 215000)
Author(s):
Xu Yongkang1;  Yun Ye1;  Zhao Yongxiang1;  Jiang Haishan1;  Zhao Jungang2;  Zhang Jianguo1;  Wu Xiangming1
1. Department of Pediatric Surgery, Fourth Municipal Hospital, Baotou 014000, China;
2. Affiliated Children’s Hospital, Soochow University, Suzhou 215003, China
关键词:
阑尾炎/诊断; 阑尾炎/免疫学; C反应蛋白质; 白介素-6; 降钙素原; 儿童
Keywords:
Appendicitis/DI; Appendicitis/IM; C-Reactive Protein; Interleukin 6; Procalcitonin; Child
分类号:
R726;R574.61
DOI:
10.12260/lcxewkzz.2021.01.012
摘要:
目的 探索血清C反应蛋白（C-reactive protein，CRP）、白介素-6（interleukin 6，IL-6）和降钙素原（procalcitonin，PCT）水平对小儿急性复杂性阑尾炎的诊断价值。方法 以2016年1月至2017年5月包头市第四医院小儿外科收治并进行手术治疗的96例急性阑尾炎患者为研究对象，分为两组：单纯性阑尾炎组30例，复杂性阑尾炎（包括化脓性阑尾炎及坏疽性阑尾炎）组66例，两组患者年龄、性别、体重差异均无统计学意义（P>0.05），检测两组患者术前血清CRP、IL-6、和PCT浓度，并绘制ROC曲线分析CRP、IL-6和PCT对小儿急性复杂性阑尾炎的诊断价值。结果 复杂性阑尾炎组CRP、IL-6及PCT水平均显著高于单纯性阑尾炎组（P<0.05）；以手术后病理结果为金标准，CRP、PCT、IL-6及三者联合检验ROC曲线下面积别为0.906（95%置信区间：0.829~0.956），0.953（95%置信区间：0.889~0.986），0.765（95%置信区间：0.668~0.846），0.973（95%置信区间：0.971~0.995）。曲线下面积值由大到小排序：PCT+CRP+IL-6 > PCT > CRP > IL-6，通过两两比较发现，联合检验曲线下面积与CRP、IL-6单独检验曲线下面积比较差异具有统计学意义（Z=2.932，P=0.003；Z=3.854，P=0.0001）；联合检验曲线下面积与PCT单独检验曲线下面积比较差异无统计学意义（Z=1.861，P=0.063）；CRP与PCT单独检验曲线下面积差异无统计学意义（Z=1.668，P=0.095），IL-6单独检验与CRP单独检验、PCT单独检验比较曲线下面积差异具有统计学意义（Z=2.312，P=0.021；Z=3.371，P=0.001）；得到最佳临界点分别为11.47（95%置信区间：11.42~14.48）mg/L，0.87（95%置信区间：0.63~0.98）ng/L，88.60（95%置信区间：87.12~170.83）pg/mL。结论 CRP、IL-6和PCT有助于临床医师对阑尾炎严重程度进行早期判断，从而早期争取家长配合，尽早手术治疗并减少并发症的发生。
Abstract:
Objective To explore the correlation between serum C-reactive protein (CRP),interleukin-6 (IL-6),procalcitonin (PCT) and acute complex appendicitis in children and examine their diagnostic values.Methods A total of 96 hospitalized children with acute appendicitis underwent operations from 2016 to 2017.They were divided into two groups of simple appendicitis (n=30,A1) and complex suppurative/gangrenous appendicitis (n=60,A2).The preoperative serum concentrations of CRP,IL-6,and PCT were measured and compared for two groups.The receiver operating characteristic (ROC) curves were plotted for analyzing the diagnostic values of CRP,IL-6 and PCT in children with acute complex appendicitis.Results No statistical significance existed in age,gender or weight between two groups (P>0.05).The levels of CRP,IL-6 and PCT were significantly higher in group A2 than those in group A1 (P<0.05).ROC curve was plotted according to the postoperative pathological results for analyzing the diagnostic efficiency of CRP,PCT and IL-6 for complicated appendicitis.AUC of CRP,PCT,IL-6 and their combined test were 0.906(95%CI:0.829-0.956),0.953(95%CI:0.889-0.986),0.765(95%CI:0.668-0.846) and 0.973(95%CI:0.971-0.995) respectively.Value of AUC was PCT+CRP+IL-6 > PCT > CRP > IL-6.AUC of combined test was statistically different from that of CRP/IL-6 (Z=2.932,P=0.003;Z=3.854,P=0.0001).No statistical difference existed between AUC of combined test and that of PCT (Z=1.861,P=0.063) or between AUC of CRP and that of PCT (Z=1.668,P=0.095);and statistical difference existed between AUC of IL-6 and that of CRP/PCT (Z=2.312,P=0.021;Z=3.371,P=0.001).The obtained optimal critical points were 11.47(95%CI:11.42-14.48) mg/L,0.87(95%CI:0.63-0.98) ng/L and 88.60(95%CI:87.12-170.83) pg/ml respectively.Conclusion Clinicians can judge the severity of appendicitis during an early stage by CRP,IL-6 and PCT so as to win the cooperation of parents,perform operations as early as possible and reduce the occurrence of complications.

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备注/Memo

收稿日期:2019-03-18。
基金项目:包头市社会发展科技支撑项目（编号：2017S2001-6-1）
通讯作者:赵永祥,Email:121418388@qq.com;姜海山,Email:584955375@qq.com

更新日期/Last Update: 2021-01-28