急性阑尾炎多层螺旋CT扫描征象与血清炎性标志物的相关性研究

Study on correlation between MSCT findings and serum inflammatory markers in acute appendicitis

目的探讨急性阑尾炎多层螺旋CT征象与血清炎性标志物的关系。方法收集2012年1月至2013年12月于同济大学附属杨浦医院经手术病理证实的具有完整临床及影像资料的急性阑尾炎患者66例,对所有患者的急性阑尾病变程度行CT分级,分析其与患者白细胞(WBC)计数、中性粒细胞百分比(NEUT%)及血清C反应蛋白(CRP)水平的相关性。结果急性阑尾炎CT分级与患者WBC计数与CRP水平呈正相关(P<0.05),穿孔性阑尾炎患者NEUT%及CRP水平明显高于其他患者。CRP水平与阑尾直径、阑尾积液、回盲部变化、阑尾周围炎性条纹、小肠积液呈正相关(P<0.05),WBC计数与回盲部变化及阑尾周围炎性条纹呈正相关(P<0.05)。结论WBC计数及CRP水平与急性阑尾炎CT分级有关,CRP对急性阑尾炎的诊断及其严重程度的判断更有优势;CRP、NEUT%是穿孔性阑尾炎的重要预测因子,WBC可以更好地发现早期阑尾周围的炎性反应,综合分析CT表现与血清炎性标志物能更准确地诊断急性阑尾炎。

Objective To investigate the correlation between the multi-slice spiral CT（MSCT）findings and the inflammatory markers in acute appendicitis.Methods 66 patients with operatively and pathologically confirmed acute appendicitis and the intact imaging data in our hospital were collected and performed the CT grading for the acute appendix lesion degrees.The correlation between the grading with the white blood cell（WBC）count,neutrophil cell percentage（NEUT%）and serum C-reactive protein（CRP）level was analyzed.Results The CT grading of acute appendicitis was positively correlated with the WBC count and CRP level（P〈0.05）.NEUT% and the CRP level in perforated appendicitis were significantly higher than those in other CT grades.The CRP level was positively correlated with the appendix diameter,appendix intraluminal hydrops,ileocecal change,appendix peripheral inflammatory stripes and intestinal hydrops（P〈0.05）.The WBC count was positively correlated with the ileocecal change and appendix peripheral inflammatory stripes（P〈0.05）.Conclusion The WBC count and CRP level may be related with the CT grading of acute appendicitis.CRP could have the advantage for diagnosing acute appendicitis and judging its serious degree,CRP and NEUT% could be the important predictive factors for perforated appendicitis,WBC could better find the early inflammatory reaction around appendix,and the comprehensive analysis of CT findings and serum inflammatory markers could accurately diagnose acute appendicitis.