免疫抑制酸性蛋白与中性粒细胞/淋巴细胞比值及血清C-反应蛋白检测对急性阑尾炎诊断的意义

The clinical significance of examining serum immunosuppressive acidic protein,C-reactive protein as well as the ratio of neutrophil vs lymphocyte in patients with acute appendicitis

目的探讨急性阑尾炎(AA)患者血清免疫抑制酸性蛋白(IAP)与外周血中性粒细胞/淋巴比值(N/L比值)以及血清C-反应蛋白(CRP)变化及对诊断的意义。方法检测AA患者术前血清IAP、CRP水平和外周WBC,并计算N/L。结果AA患者血清IAP水平均较对照组明显升高(P<0.01),坏疽或穿孔性组较急性单纯性与化脓性阑尾炎组明显升高(P<0.01)。N/L比值明显高于对照组;病情越严重,N/L比值越高。AA患者CRP水平高于对照组(P<0.01),坏疽或穿孔性组CRP水平较急性单纯性与化脓性阑尾炎组又有明显升高(P<0.01)。IAP、CRP与N/L比值联合检测对白细胞计数正常的AA诊断有重要意义,对这部分AA预测的准确率达100%(42/42)。结论IAP、N/L比值及CRP能比较准确地反映AA的病情,三者联合检测能进一步提高对AA诊断的准确性。

Objective To study the changes and their clinical significance of serum immunosuppressive acidic protein（IAP）,C-reactive protein（CRP） and the ratio of neutrophil vs lymphocyte（N/L ratio） in patients with acute appendicitis.Methods The preoperative serum IAP and CRP levels,leukocyte count as well as N/L ratio were determined in 151 patients with acute appendicitis.Results The serum IAP levels in patients were significantly higher than those of healthy people（normal control group）（P〈0.01）,and the serum IAP levels in patients with gangrenous or perforated appendicitis were significantly higher than those with simple or suppurative appendicitis（P〈0.01）.The N/L ratios in patients were significantly higher than those of the control group（P〈0.01）.The N/L ratio increased when the patients＇ condition worsened.There was a significant difference in CRP levels between the patients with acute appendicitis and the control group（P〈0.01）,and the serum CRP levels in patients with gangrenous or perforated appendicitis were significantly higher than those with simple or suppurative appendicitis（P〈0.01）.The combined examination of IAP,CRP and N/L ratio may improve the accuracy of diagnosis in patients with normal leukocyte count,and the accuracy of diagnosis in current study was 100%（42/42）.Conclusion The changes of preoperative IAP and CRP levels as well as N/L ratio may reflect the patients＇ conditions more accurately,suggesting this triplex examination can improve the accuracy of diagnosis.