降钙素原在儿童急性阑尾炎及肠系膜淋巴结炎诊治中的评价

The evaluation of procalcitonin in diagnosing acute appendicitis and mesenteric lymphadenitis in chil- dren

目的：探讨血清降钙素原（PCT）在鉴别儿童急性阑尾炎及肠系膜淋巴结炎中的意义。方法回顾性分析2008年7月至2013年7月我们收治的儿童急性阑尾炎（为阑尾炎组）和急性肠系膜淋巴结炎（为肠系膜淋巴结炎组）患儿临床资料。其中阑尾炎组42例，急性肠系膜淋巴结炎组36例，比较两组治疗前后 PCT、C —反应蛋白（CRP）和白细胞计数（WBC），以及这三种指标诊断的特异性、敏感性、阳性预测值和阴性预测值。结果治疗前急性阑尾炎组 PCT 检测结果明显高于正常值，而急性肠系膜淋巴结炎组 PCT 检测结果基本正常，且两组差异有显著统计学意义（P ＜0．01）；治疗3 d 后两组PCT 检测结果均基本正常，差异无统计学意义（P ＞0．05）；以 PCT ＞0．5 ng／mL 作为诊断指标时，特异性、敏感性、阳性预测值、阴性预测值均高于 CRP 及 WBC。结论早期检测 PCT 有助于儿童急性阑尾炎与肠系膜淋巴结炎的鉴别诊断。

Objective To investigate the evaluation of procalcitonin in the diagnostic value of acute ap-pendicitis and mesenteric lymphadenitis in child.Methods The clinical data of acute appendicitis and mesen-teric lymphadenitis in children from July.2008 to July.2013 were reviewed.They were divided into the appen-dicitis group of 42 cases and the mesenteric lymphadenitis group of 36 cases.The detection results of PCT、CRP、WBC before and after treatment were compared.Meanwhile,the specificity,sensitivity,positive and nega-tive predictive value were compared.Results PCT of the acute appendicitis group was higher than that of the mesenteric lymphadenitis group before the treatment （P 〈0.01）.while,there were,not significant difference between them after 3 days of the treatment （P 〉0.05）.When PCT（〉0.5 ng/mL）was used as a diagnostic indicator,specificity,sensitivity,positive and negative predictive value were higher than CRP and WBC. Con-clusions Early detection of PCT are helpful to differential diagnosis between acute appendicitis and mesenteric lymphadenitis in children.