WBC计数和血清C-反应蛋白在阑尾炎的诊断及病情评估中的价值
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摘要
目的探讨白细胞计数(WBC)、血清C-反应蛋白(CRP)水平在急性阑尾炎的诊断及病情评估中的价值。方法 178例急性阑尾炎患者,经手术和病理结果诊断为65例坏疽性阑尾炎及穿孔、73例化脓性阑尾炎和40例单纯性阑尾炎;58例疑似阑尾炎腹痛患者为对照组。回顾性分析3组患者手术前或术后第5 d WBC和CRP检测结果,与对照组比较,并进行统计学分析。结果从对照组、单纯性阑尾炎组、化脓性阑尾炎组、坏疽性阑尾炎及穿孔组术前CRP检测结果逐步升高,且各组间比较差异均有统计学意义(P<0.05),坏疽性阑尾炎及穿孔组与化脓性阑尾炎组术前WBC与单纯性阑尾炎组和对照组比差异均有统计学意义(P<0.05)。各组患者术后第5 d WBC和CRP与术前比较差异均有统计学意义(P<0.05)。诊断急性阑尾炎WBC灵敏度明显高于CRP,而特异度则是血清CRP明显高于WBC。结论 WBC和血清CRP检测对于急性阑尾炎的诊断及病情评估有重要意义。
Objective To discuss the diagnostic and severity evaluation value of WBC and C-reactive protein(CRP) in acute appendicitis. Methods A total of 178 acute appendicitis patients, including 65 gangrenous and perforated appendicitis, 73 pyogenic appendicitis and 40 simple appendicitis, and 58 patients with suspected appendicitis abdominal pain were selected as the control group. The results of WBC and CRP before and after surgery were compared retrospectively in the three groups, which were compared with the control group, and statistical analysis was performed. Results Preoperative CRP results in the control group, simple appendicitis group, suppurative appendicitis group, gangrenous appendicitis and perforation group gradually increased, and the differences among the groups were statistically significant(P<0.05). The preoperative WBC of the appendicitis gangrene group and the suppurative appendicitis group were compared with that in the simple appendicitis group and the control group, with the differences statistically significant(P<0.05). WBC and CRP on the 5 th day after operation were compared with those before operation, with the differences statistically significant(P<0.05). In the diagnosis of acute appendicitis, WBC′s sensitivity was significantly higher than CRP′s, and serum CRP′s specificity was significantly higher than WBC′s. Conclusion The detection of WBC and serum CRP has important value for predicting the severity of acute appendicitis.
Objective To discuss the diagnostic and severity evaluation value of WBC and C-reactive protein(CRP) in acute appendicitis. Methods A total of 178 acute appendicitis patients, including 65 gangrenous and perforated appendicitis, 73 pyogenic appendicitis and 40 simple appendicitis, and 58 patients with suspected appendicitis abdominal pain were selected as the control group. The results of WBC and CRP before and after surgery were compared retrospectively in the three groups, which were compared with the control group, and statistical analysis was performed. Results Preoperative CRP results in the control group, simple appendicitis group, suppurative appendicitis group, gangrenous appendicitis and perforation group gradually increased, and the differences among the groups were statistically significant(P<0.05). The preoperative WBC of the appendicitis gangrene group and the suppurative appendicitis group were compared with that in the simple appendicitis group and the control group, with the differences statistically significant(P<0.05). WBC and CRP on the 5 th day after operation were compared with those before operation, with the differences statistically significant(P<0.05). In the diagnosis of acute appendicitis, WBC′s sensitivity was significantly higher than CRP′s, and serum CRP′s specificity was significantly higher than WBC′s. Conclusion The detection of WBC and serum CRP has important value for predicting the severity of acute appendicitis.
引文
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[11] 王天野, 赵海鹰, 孙文郁, 等. 手术时机对急性阑尾炎预后影响研究[J]. 中国实用外科杂志, 2017, 37(2):179-181.
[12] 胡建芬, 伍江雁, 张林, 等. 高迁移率族蛋白B1对儿童急性阑尾炎的诊断价值[J]. 中国当代儿科杂志, 2016, 16(9):919-921.
[13] 黄卫, 朱静. 急性阑尾炎患者血清降钙素原检测的临床意义[J]. 实用医院临床杂志, 2015, 17(5):217-218.
[14] 陈琦, 钮宏文. 降钙素原、C反应蛋白及白细胞计数在急性复杂型阑尾炎中的诊断价值[J]. 贵州医药, 2016, 40(10): 1048-1049.
[15] 辛少军, 高敏, 张宗新. presepsin在急性阑尾炎的诊断及病情评估中的价值[J]. 中国卫生检验杂志, 2017, 27(1):82-84.
[2] 汪鑫, 宋茂民. 实验室检查在急性阑尾炎诊断中的现状及进展[J]. 中华实用诊断与治疗杂志, 2016, 30(4): 331-333.
[3] 夏禹, 黄瑛, 富聪聪, 等. 超声与CT诊断小儿急慢性阑尾炎的对比分析[J].中国临床医学影像杂志, 2014, 24(11): 793-796.
[4] 韦德才, 蒋邦好, 周思栋, 等. 急性阑尾炎患儿C-反应蛋白和白细胞计数检测的临床意义[J]. 中国实用医药, 2012, 7(3): 3-4.
[5] 张永生, 徐礼治, 伍阳阳. 白细胞计数和C-反应蛋白诊断急性阑尾炎的准确性与患者症状持续时间关联性探讨[J]. 中国卫生检验杂志, 2017, 27 (10):1467-1470, 1473.
[6] 朱秋良. D-二聚体,降钙素原和C反应蛋白在急性阑尾炎中的评价[J]. 国际检验医学杂志, 2013,34(17):2248-2249.
[7] 庄国华,施前锋,孙爱华. 降钙素原在阑尾炎的诊断及病情评估中的价值[J]. 中国卫生检验杂志, 2018, 28(10): 1209-1211.
[8] 韦德才, 蒋邦好, 周思栋, 等. 急性阑尾炎患儿C-反应蛋白和白细胞计数检测的临床意义[J]. 中国实用医药, 2012, 7(3):3-4.
[9] 宋世琦. 应用抗生素治疗急性单纯性阑尾炎的策略及其价值[J]. 中国卫生标准管理, 2015, 6(10): 195-196.
[10] 徐大华, 刘东斌.急性阑尾炎腹腔镜手术指征及技巧[J]. 中国实用外科杂志, 2015, 37(5):499-502.
[11] 王天野, 赵海鹰, 孙文郁, 等. 手术时机对急性阑尾炎预后影响研究[J]. 中国实用外科杂志, 2017, 37(2):179-181.
[12] 胡建芬, 伍江雁, 张林, 等. 高迁移率族蛋白B1对儿童急性阑尾炎的诊断价值[J]. 中国当代儿科杂志, 2016, 16(9):919-921.
[13] 黄卫, 朱静. 急性阑尾炎患者血清降钙素原检测的临床意义[J]. 实用医院临床杂志, 2015, 17(5):217-218.
[14] 陈琦, 钮宏文. 降钙素原、C反应蛋白及白细胞计数在急性复杂型阑尾炎中的诊断价值[J]. 贵州医药, 2016, 40(10): 1048-1049.
[15] 辛少军, 高敏, 张宗新. presepsin在急性阑尾炎的诊断及病情评估中的价值[J]. 中国卫生检验杂志, 2017, 27(1):82-84.