摘要
目的探讨降钙素原(PCT)检测在儿童急性阑尾炎和肠系膜淋巴结炎鉴别诊断中的应用。方法 40例急性阑尾炎患儿设为阑尾炎组,38例急性肠系膜淋巴结炎患儿设为淋巴结炎组。检测2组患儿入院第1、4天白细胞(WBC)、C反应蛋白(CRP)及PCT水平,分析入院第1天各指标诊断急性阑尾炎的敏感度、特异度,绘制受试者工作特征曲线(ROC曲线)。结果入院第1天,阑尾炎组WBC、CRP及PCT水平均显著高于淋巴结炎组(P<0.05或P<0.01);入院第4天,阑尾炎组各指标均显著下降(P<0.05或P<0.01),淋巴结炎组WBC显著下降(P<0.01),2组间各指标差异无统计学意义(P>0.05)。ROC曲线分析显示,入院第1天PCT的曲线下面积为0.810,分别高于WBC的0.582和CRP的0.791,且PCT诊断急性阑尾炎的敏感度和敏感度分别90.00%和84.21%,优于WBC和CRP。结论急性阑尾炎患儿疾病早期血清PCT、CRP及WBC均显著升高,其中PCT的诊断性能优于CRP和WBC,可作为与急性肠系膜淋巴结炎鉴别诊断的参考指标之一。
Objective To investigate the value of procalcitonin （PCT） in diagnosis of acute appendicitis and mesenteric lymphadenitis in children. Methods This study included 40 children with acute appendicitis （as the appendicitis group） and 38 children with mesenteric lymphadenitis （as the lymphadenitis group）. The white blood cell （WBC） count, levels of C-reactive protein （CRP） and PCT on first day and 4th day after admission were observed. The receiver operating characteristic （ROC） curve was used to analyze the sensitivity and specificity of each indicator on first day after admission. Results Levels of WBC, CRP and PCT were significantly higher in appendicitis group than those in the lymphadenitis group on first day after admission （ P 〈 0.05 or P 〈 0.01 ）. Levels of all indicators in appendicitis group, as well as WBC in lymphadenitis group, were dropped on 4＊h day after admission （P 〈 0.05 or P 〈 0.01 ）, but with no significant difference between two groups （ P 〉 0.05 ）. ROC curve analysis showed that the area under the curve （AUC） of PCT on first day after admission was 0.810 （ sensitivity： 90.00% , specificity： 84.21% ）, which was higher than that of WBC （AUC： 0. 582, sensitivity： 70.00%, specificity： 60.53% ） and CRP （AUC： 0.791, sensitivity： 85.00%, specificity： 63.16% ）. Conclusion Findings indicate an increased level of WBC, CRP and PCT in early stage of acute appendicitis. Early detection of PCT is more effective in differential diagnosis of acute appendicitis and mesenterie lymphadenitis in children compared with the WBC and CRP.
出处
《实用临床医药杂志》
CAS
2016年第13期80-82,共3页
Journal of Clinical Medicine in Practice
基金
中国高校医学期刊临床专项资金(11527750)
关键词
急性阑尾炎
急性肠系膜淋巴结炎
儿童
白细胞
C反应蛋白
降钙素原
acute appendicitis
acute mesenteric lymphadenitis
children
white blood cell
C-reactive protein
procalcitonin
