摘要
目的 探讨术前C反应蛋白(CRP)、血浆纤维蛋白原(FIB)及血清中性粒细胞/淋巴细胞比值(NLR)联合检测对儿童复杂性急性阑尾炎的预测价值.方法 回顾性分析 2023 年1月至 6 月重庆医科大学附属儿童医院普外新生儿外科收治的 320 例急性阑尾炎患儿的临床资料,依据病理类型分为复杂性急性阑尾炎组(149例)和非复杂性急性阑尾炎组(171例).比较两组白细胞(WBC)、中性粒细胞(Neu)、淋巴细胞(Lym)、血小板/淋巴细胞比值(PLR)、CRP、FIB等水平,采用多因素logistic回归分析复杂性急性阑尾炎发生的危险因素,并采用受试者工作特征曲线分析联合检测对儿童复杂性急性阑尾炎的预测价值.结果 复杂性急性阑尾炎组术前WBC、Neu、CRP、FIB、NLR、PLR高于非复杂性急性阑尾炎组,Lym低于非复杂性急性阑尾炎组(P<0.05);多因素logistic回归分析结果显示,CRP、FIB、NLR是复杂性急性阑尾炎的独立危险因素(P<0.05);CRP、FIB及NLR三者联合检测复杂性急性阑尾炎的曲线下面积大于CRP、FIB及NLR单独检测(P<0.05).结论 FIB、CRP、NLR联合检测对儿童复杂性急性阑尾炎的预测价值较高,能够为临床早期评估急性阑尾炎的严重程度提供依据.
Abstract
Objective To investigate the predictive value of combined detection of preoperative C-reactive protein(CRP),fibrinogen(FIB)and serum neutrophil to lymphocyte ratio(NLR)in children with complicated acute appendicitis.Methods The clinical data of 320 children with acute appendicitis admitted to the Department of General and Neonatal Surgery,Children's Hospital of Chongqing Medical University from January to June 2023 were retrospectively analyzed.According to the pathological type,they were divided into complicated acute appendicitis group(149 cases)and uncomplicated acute appendicitis group(171 cases).The levels of white blood cell(WBC),neutrophil(Neu),lymphocyte(Lym),platelet to lymphocyte ratio(PLR),CRP and FIB were compared between the two groups.Multivariate logistic regression was used to analyze the risk factors of complicated acute appendicitis,and the receiver operating characteristic curve was used to analyze the predictive value of combined detection for complicated acute appendicitis in children.Results The preoperative WBC,Neu,CRP,FIB,NLR and PLR in the complicated acute appendicitis group were higher than those in the uncomplicated acute appendicitis group,and Lym was lower than that in the uncomplicated acute appendicitis group(P<0.05).Multivariate logistic regression analysis showed that CRP,FIB and NLR were independent risk factors for complicated acute appendicitis(P<0.05).The area under the curve of CRP,FIB and NLR combined detection of complicated acute appendicitis was larger than that of CRP,FIB and NLR alone(P<0.05).Conclusion The combined detection of FIB,CRP and NLR has a high predictive value for complicated acute appendicitis in children,which can provide a basis for early clinical evaluation of the severity of acute appendicitis.
维普
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