尿常规检验与C-反应蛋白对小儿急性阑尾炎的诊断价值比较

Comparison of diagnostic value of routine urine test and CRP for acute appendicitis in children

目的探讨尿常规检验与C-反应蛋白对小儿急性阑尾炎的鉴别效果的差异。方法选择2011年2月至2013年8月,浙江省上虞区妇幼保健院收治的小儿急性阑尾炎患者共537例进行回顾性分析。术前均行尿常规检验(尿常规组)及C-反应蛋白检查(C-反应蛋白组),以术后确诊结果为指标,比较检验方法对不同类型阑尾炎的检出率及两种方法的敏感度的差异。结果尿常规法对阑尾炎患者的检出率为86.94%;C-反应蛋白法对阑尾炎患者检出率为98.14%,差异具有统计学意义(t=5.81,P=0.031)。尿常规对急性化脓性阑尾炎的检出率优于急性单纯性阑尾炎的检出率(x～2=32.007,P<0.05),对急性坏疽穿孔性阑尾炎的检出率亦优于急性单纯性阑尾炎的检出率(Fisher检验法得出P=0.031<0.05);C-反应蛋白对3种类型的诊断结果没有显著性差异(x～2=6.627,P>0.05);与尿常规对不同类型阑尾炎的检出率相比,C-反应蛋白对于急性单纯性阑尾炎的检出率较高(x～2=66.047,P<0.05)。结论 C-反应蛋白相对于尿常规比较,检出率更高,灵敏度更高,但C反应蛋白的检测时间较长,检测较为繁琐,因此临床应根据实际情况合理按排检测方法。

Objective To investigate the difference in effect of urine routine test and C-reactive protein （ CRP ） detection on acute appendicitis in children .Methods Retrospective analysis was conducted on 537 children with acute appendicitis admitted in Shangyu Maternal and Child Health Hospital from February 2011 to August 2013.The cases underwent routine urine test （urine group） or CRP detection （ CRP group） .The confirmed diagnosis after operation was taken as indicator to compare two groups in the detection rate and sensitivity.Results The detection rate of urine group and CRP group was 86.94% and 98.14%, respectively, and the difference was significant（t=5.81,P=0.031）.The detection rate of routine urine test on acute suppurative appendicitis was superior to that on acute simple appendicitis （χ^2 =32.007, P 〈0.05）, and that on acute gangrene perforation appendicitis was also superior to acute simple appendicitis （P=0.031〈0.05）.The detection rate of CRP on three types of appendicitis was not significantly different （χ^2 =6.627,P〉0.05）.Compared with the detection rate of routine urine test on different types of appendicitis , the detection rate of CRP on acute simple appendicitis was higher （χ^2 =66.047, P〈0.05）.Conclusion Compared with routine urine test, CRP has higher detection rate and higher sensitivity but with long examining time and procedure .Therefore, clinical situation should be considered in selecting examination method .