中国现代普通外科进展2024,Vol.27Issue(7) :533-537.DOI:10.3969/j.issn.1009-9905.2024.07.006

未成熟粒细胞百分比在预测儿童急性阑尾炎严重程度中的临床价值

Clinical value of immature granulocyte percentage in pre-dicting severity of acute appendicitis in children

张新丽 李凯江 赵蒲宇 赵亮 梁冰 卢东方 施玉成
中国现代普通外科进展2024,Vol.27Issue(7) :533-537.DOI:10.3969/j.issn.1009-9905.2024.07.006

未成熟粒细胞百分比在预测儿童急性阑尾炎严重程度中的临床价值

Clinical value of immature granulocyte percentage in pre-dicting severity of acute appendicitis in children

张新丽 1李凯江 2赵蒲宇 1赵亮 1梁冰 1卢东方 1施玉成1
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作者信息

  • 1. 周口市中心医院检验科(河南 周口 466000)
  • 2. 周口市中心医院普通外科(河南 周口 466000)
  • 折叠

摘要

目的:探讨未成熟粒细胞百分比(IG%)及其他炎症指标联合检测在评估儿童急性阑尾炎(AA)严重程度中的临床价值.方法:纳入2022年6月-2023年8月行手术治疗的AA患儿201例,其中单纯性阑尾炎105例(ASA组),复杂性阑尾炎96例(ACA组).比较两组白细胞(WBC)、中性粒细胞计数(ANC)、淋巴细胞计数(ALC)、中性粒细胞与淋巴细胞比值(NLR)、IG%、降钙素原(PCT)、C反应蛋白(CRP)、血小板与淋巴细胞比值(PLR)等指标的差异,Logistic回归分析构建回归模型,并利用受试者工作特征(ROC)曲线评估各指标及回归模型对ACA的诊断价值.另外,纳入2023年9月-2024年2月的AA患儿156例为验证队列,对Logistic模型进行验证,并用ROC曲线分析该模型对于ACA的诊断价值.结果:ACA组IG%、WBC、ANC、NLR、PCT、CRP和PLR水平均高于ASA组(P均<0.05),ALC水平低于ASA组(P=0.003).Logistic回归分析显示,IG%、NLR和CRP是诊断儿童ACA的影响因素(P均<0.05),以此建立模型,以模型判断ACA的预测概率和单个炎症指标绘制ROC曲线,该模型预测概率和IG%、NLR、CRP的AUC分别为0.868和0.821、0.691和0.790,差异有统计学意义(P均<0.001).通过独立队列验证Logistic模型,AUC为0.872,模型拟合较好,敏感度为90.0%,特异度为75.6%.结论:IG%可作为早期鉴别儿童ASA和ACA的重要指标,包括IG%、NLR、CRP这3项炎症标志物的Logistic回归模型对儿童ACA有良好的临床诊断价值.

Abstract

Objective:To investigate the clinical value immature granulocyte percentage(IG%)and other inflammatory indicators in the severity of acute appendicitis.Methods:A total of 201 pediatric patients undergoing appendicitis surgery admitted to Zhoukou Central Hospital from June 2022 to August 2023 were included.Patients with pathologically confirmed actue appendici-tis were divided two subgroups:actue simple appendicitis(ASA)group and actue complicated ap-pendicitis(ACA)group,The variables that included IG%,white blood cell(WBC)count,absolute neutrophil count(ANC),absolute lymphocyte count(ALC),neutrophil to lymphocyte ratio(NLR),pro-calcitonin(PCT),C-reactive protein(CRP),platelet to lymphocyte(PLR)and other indexes were ana-lyzed between ASA and ACA group.The logistic regression model for diagnosis of ACA was es-tablished,and the diagostic value of this model and other inflammtory indicators for ACA was evaluated by receiver operating characteristic(ROC)curve analysis.Results:The levels of IG%,WBC,ANC,ALC,NLR,PCT and PLR were higher and the level of ALC was lower in ACA group than those in ASA group(all P<0.05).Logistic regression analysis showed that IG%,NLR and CRP were three diagnostic determinants of ACA(all P<0.05).The AUC of the established logistic model and IG%,NLR,CRP were 0.868,0.821,0.691 and 0.790(all P<0.001).The logistic model was vali-dated by independent cohorts,and the AUC was 0.872,the sensitivity was 90.0%and the speci-ficity was 75.6%.Conlusions:The IG%value can early indicator for pediatric ACA,and the es-tablished logistic regression model based on biomarkers including IG%,NLR and CRP has clinical value in diagnosing ACA in children.

关键词

未成熟粒细胞百分比/急性阑尾炎/炎症标志物

Key words

Immature granulocyte percentage/Acute appendicitis/Inflammatory indicator

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出版年

2024
中国现代普通外科进展
山东大学

中国现代普通外科进展

CSTPCD
影响因子:0.993
ISSN:1009-9905
参考文献量2
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