血清CXC趋化因子受体3、干扰素诱导蛋白-10水平对儿童急性阑尾炎伴穿孔的诊断价值

The diagnostic value of the levels of serum CXCR3 and IP-10 in children with acute appendicitis with perforation

目的 分析血清CXC趋化因子受体3(CXCR3)、干扰素诱导蛋白-10(IP-10)水平对儿童急性阑尾炎伴穿孔的诊断价值。方法 选取2019年3月至2022年2月我院小儿外科收治的急性阑尾炎患儿165例,根据是否发生阑尾穿孔分为穿孔组61例与未穿孔组104例,同时选取在我院进行体检的健康儿童60例为对照组。检测所有受试儿童生化指标和血清CXCR3、IP-10水平;分析急性阑尾炎伴穿孔患儿血清CXCR3、IP-10水平及与生化指标的相关性,血清CXCR3、IP-10、二者联合对急性阑尾炎患儿发生穿孔的诊断价值及穿孔的影响因素。结果 白细胞计数(WBC)、中性粒细胞计数(NEUT)、血小板计数(PLT)、中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)、血清CXCR3、IP-10水平比较,穿孔组>未穿孔组>对照组(P<0.05);急性阑尾炎伴穿孔患儿血清CXCR3与IP-10水平呈正相关(P<0.05),血清CXCR3、IP-10与WBC、NEUT、PLT、NLR、CRP均呈正相关(P<0.05);血清CXCR3、IP-10、二者联合诊断急性阑尾炎患儿发生穿孔的曲线下面积分别为0.920、0.860、0.960,敏感度分别为91.80%、68.85%、85.25%,特异度分别为78.85%、87.50%、94.23%;CXCR3、IP-10、WBC、NEUT、PLT、NLR、CRP均是影响急性阑尾炎患儿发生穿孔的独立危险因素(P<0.05)。结论 急性阑尾炎伴穿孔患儿血清CXCR3、IP-10水平均升高,二者呈正相关,联合检测有助于诊断急性阑尾炎伴穿孔的发生。

Objective To analyze the diagnostic value of the levels of serum CXC chemokine receptor 3(CXCR3) and interferon induced protein-10(IP-10) in acute appendicitis with perforation in children.Methods A total of 165 children with acute appendicitis admitted to the department of pediatric surgery in our hospital from March 2019 to February 2022 were selected. According to whether appendiceal perforation occurred, they were divided into a perforation group(n=61) and a non-perforation group(n=104). At the same time, 60 healthy children who underwent physical examination in our hospital were selected as a control group. The biochemical indexes and the levels of serum CXCR3 and IP-10 of all children were detected. The correlation between the levels of serum CXCR3 and IP-10 and the biochemical indexes in the sick children was analyzed. The diagnostic value of serum CXCR3, IP-10 and their combination in the determination of perforation of acute appendicitis and the influencing factors of perforation were also analyzed.Results The levels of white blood cell(WBC) count, neutrophil count(NEUT), platelet count(PLT), neutrophil lymphocyte ratio(NLR), C-reactive protein(CRP), serum CXCR3 and IP-10 were increased in the control group, non-perforated group and perforated group(P<0.05). The levels of serum CXCR3 and IP-10 in children with acute appendicitis with perforation were positively correlated(P<0.05), and the levels of serum CXCR3 and IP-10 were positively correlated with WBC, NEUT, PLT, NLR and CRP(P<0.05). The areas under ROC curves of serum CXCR3 and IP-10 as well as their combination for diagnosis of perforation in the sick children were 0.920, 0.860 and 0.960, respectively. The corresponding sensitivity was 91.80%, 68.85% and 85.25%, and the specificity were 78.85%, 87.50% and 94.23%, respectively. CXCR3, IP-10, WBC, NEUT, PLT, NLR and CRP were independent risk factors for perforation in children with acute appendicitis(P<0.05).Conclusions The levels of serum IP-10 and CXCR3 in children with acute appendicitis with perforation are increased. The two indexes are positively correlated. The combined detection of the two would be helpful in diagnosing the occurrence of acute appendicitis with perforation.