C-反应蛋白诊断化脓穿孔性阑尾炎价值的研究

Diagnostic Value of C-reactive Protein in Gangrenous and Perforation Appendicitis

目的探讨C-反应蛋白诊断化脓穿孔穿孔性阑尾炎的价值。方法 156例于本院2008年1月至2011年12月实施阑尾切除术的患者纳入本次研究,Logistic回归多因素回顾性分析化脓穿孔性阑尾炎(研究组)较单纯性阑尾炎(对照组)发病的危险因素;ROC分析C-反应蛋白诊断化脓穿孔性阑尾炎的截断值、敏感度、特异度和Youden指数。结果 Logistic回归分析显示年龄、发病时间、阑尾直径和CRP是化脓穿孔阑尾炎发病的危险因素,CRP最佳诊断截断值为75mg/L,敏感度为58.4%,特异度为97.8%,Youden指数为0.557。结论 CRP>75mg/L时可以较好地预测化脓穿孔性阑尾炎的发生,及时手术治疗可避免更严重并发症的发生。

Objective To determine the diagnostic value of C-reactive protein in gangrenous and perforation appendicitis. Methods The risk factors of gangrenous and perforation appendicitis （study group） compared with those of simple appendicitis （control group） were retrospectively analyzed by Logistic regression. The cut-off value of C-reactive protein （CRP） was defined by drawing the receiver operating characteristic （ROC） curve with the relationship of sensitivity and specificity and obtaining the highest Youden index. Results The Logistic regression analysis showed age, duration time, diameter of appendix and CRP to be significant factors for gangrenous and perforation appendicitis. When CRP was 75 mg/L, the Youden index was 0.557, and the sensitivity was 58.4%, the specificity 97.8%. Conclusions This study suggests that if CRP is above 75 mg/L, immediate surgical management should be performed due to a high probability of complicated appendicitis.