血液检测指标在急性阑尾炎诊断中的应用价值

Application value of blood detection indicators in diagnosis of acute appendicitis

目的 :探讨血液检测指标在急性阑尾炎诊断中的应用价值。方法 :将2015年7月至2017年7月期间在佛山市高明区人民医院普外科进行手术治疗的395例急性阑尾炎患者作为研究对象。将这395例患者分为ACA(复杂性阑尾炎)组、ASA(急性化脓性阑尾炎)组和NSA(非化脓性阑尾炎)组。对这三组患者均进行血液检测,再使用ROC(绘制受试者工作特征)曲线对其病情进行预测评估。对三组患者均进行阑尾炎切除术。然后,比较三组患者的NLR(中性粒细胞与淋巴细胞的比值)、FIB(纤维蛋白原)的水平、INR(血浆国家标准化值)、TBILT(总胆红素)的水平、DBILT(直接胆红素)的水平和IBILT(间接胆红素)的水平;再根据其手术检查的结果,比较三组患者的ROC曲线预测价值。结果 :ACA组患者和ASA组患者的NLR均高于NSA组患者,ACA组患者的FIB的水平和INR均高于ASA组患者和NSA组患者,ASA组患者TBILT的水平、DBILT的水平和IBILT的水平均高于NSA组患者,差异有统计学意义(P<0.05)。NLR、FIB、TBILT、DBILT和IBILT在ROC曲线下的面积分别为0.856、0.773、0.732、0.717、0.729,具有中等预测价值;INR在ROC曲线下的面积为0.672,其预测价值稍低。结论 :血液检测指标在急性阑尾炎诊断中具有很高的应用价值。

objective： to explore the application value of blood test indexes in the diagnosis of acute appendicitis. Methods： 395 patients with acute appendicitis who underwent surgical treatment in general surgery of people＇ s hospital of gaoming district, foshan from July 2015 to July 2017 were studied. The 395 patients were divided into the ACA （complex appendicitis） group, the ASA （acute purulent appendicitis） group and the NSA （non-purulent appendicitis） group. All patients in the three groups were given blood tests, and their condition was predicted and assessed using ROC curve. Three groups of patients were treated with appendicitis. Then, the levels of NLR （ratio of neutrophil to lymphocyte）, FIB （fibrinogen）, INR （plasma national standardized value）, TBILT （total bilirubin）, DBILT （direct bilirubin） and IBILT （indirect bilirubin） were compared between the three groups. Based on the results of surgical examination, the ROC curves of the three groups were compared to predict value. Results： both the ACA group and the ASA group had higher NLR than the NSA group, the FIB level and INR of the ACA group were higher than those of the ASA group and the NSA group, and the TBILT level, DBILT level and IBILT level of the ASA group were higher than those of the NSA group, with statistically significant differences （P 〈 0.05）. The area under ROC curve of NLR, FIB, TBILT, DBILT and IBILT is 0.856, 0.773, 0.732, 0.717 and 0.729 respectively, which has medium predictive value. The area of INR under the ROC cUrve is 0.672, and its predictive value is slightly lower. Conclusion： blood test index is very valuable in the diagnosis of acute appendicitis.