高迁移率族蛋白B1对儿童急性阑尾炎的诊断价值

Diagnostic value of high mobility group box 1 for acute appendicitis in children

目的探讨高迁移率族蛋白B1（HMGB1）对儿童急性阑尾炎的诊断价值。方法 2013年1~7月门诊及住院疑似急性阑尾炎的急腹症患儿及同期来院体检的25名健康儿童纳入该研究。入院后采用ELISA检测血清HMGB1水平。根据手术所见及病理学检查结果等将患儿分为急性阑尾炎组（n=28）和非急性阑尾炎急腹症组（n=35）。结果急性阑尾炎组和非急性阑尾炎急腹症组外周血WBC、血清HMGB1均显著高于健康儿童组（P〈0.01）。急性阑尾炎组血清HMGB1高于非急性阑尾炎急腹症组（中位数32.9 ng/mL vs 22.0 ng/mL,P〈0.01）。HMGB1诊断儿童急性阑尾炎的最佳阈值为28.0 ng/mL,敏感性为71.4%,特异性为82.9%,曲线下面积为0.765（95%CI 0.638~0.893）,准确度为77.8%。结论 HMGB1对儿童急性阑尾炎具有一定的诊断价值。

Objective To evaluate the value of high mobility group box 1（HMGB1） in the diagnosis of pediatric acute appendicitis. Methods The children with acute abdomen who had a diagnosis of suspected acute appendicitis between January and July 2013 and 25 healthy children were enrolled in this study. Serum HMGB1 levels were measured using ELISA on admission. The patients were classified into 2 groups according to surgery confirmation or pathological results： appendicitis（n=28） and non-appendicitis（n=35）. Results Serum HMGB1 levels and WBC in the appendicitis and non-appendicitis groups were significantly higher than in the healthy children group（P〈0.01）. The appendicitis group showed more increased serum HMGB1 levels compared with the non-appendicitis group（median： 32.9 ng/mL vs 22.0 ng/mL; P〈0.01）. For a diagnosis of acute appendicitis, the sensitivity and specificity of serum HMGB1 was 71.4% and 82.9% respectively at the best cutoff of 28.0 ng/mL, with the accuracy of 77.8% and the area under the curve of 0.765（95%CI 0.638-0.893）. Conclusions HMGB1 may play a role in the diagnosis of pediatric acute appendicitis.