急性阑尾炎患者血清免疫抑制酸性蛋白测定的意义

The clinical significance of detection of serum immunosuppressive acidic protein in patients with acute appendicitis

目的探讨急性阑尾炎(AA)患者血清中免疫抑制酸性蛋白(IAP)水平的变化及意义。方法检测151例AA患者术前、术后的血清IAP水平、外周血中性粒/淋巴细胞(N/L)比值等指标。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AA较单纯性和化浓性AA组明显升高(P<0.01)。3组AA患者术后第2天血清IAP水平较术前均有明显升高(P<0.01);术后第5天有所下降,但仍较对照组为高(P<0.01)。AA患者N/L比值明显高于对照组(P<0.01)。对术前外周血白细胞计数正常的患者,用IAP和N/L比值联合检测,可提高对不典型急性阑尾炎诊断的准确性。结论AA患者手术前后IAP检测能准确反映机体免疫抑制的程度,提高诊断准确性,指导临床治疗。

Objective To investigate the change and its clinical significance of serum immunosuppressive acidic protein （lAP） in patients with acute appendicitis, nelhods Serum IAP, leukocyte count and neutrophil： lymphocyte ratio（n：l ratio） were determined in 151 patients with acute appendicitis. Results The IAP levels in patients were significantly higher than those in control group（ P 〈 0.01 ）. The IAP levels in patients with gangrenous or perforated appendicitis were significantly higher than those with simple or suppurative appendicitis（ P 〈 0.01）. The IAP levels on the second postoperative day were significantly higher than those on preoperative day. Although the tAP levels decreased on the fifth postoperative day, which were still significantly higher than those in control group（ P 〈 0.01）. The n：l ratio in patients was significantly higher than that in control group（ P 〈 0.01）.The combination of IAP and n：l ratio might improve the accuracy of diagnosis in patients with normal leukocyte count. Conclusion The detection of preoperative and postoperative IAP levels may reflect the patients＇ condition accurately, improve the accuracy of diagnosis and direct the clinical treatment.