中性粒细胞淋巴细胞比值、白细胞计数、C反应蛋白在小儿复杂性阑尾炎的诊断价值分析

Diagnostic value of neutrophil lymphocyte ratio,white blood cellcount and C-reactiveprotein in pediatriccomplicated appendicitis

目的探讨中性粒细胞淋巴细胞比值(neutrophil lymphocyteratio,NLR)、白细胞计数(WBC)、C反应蛋白(C-reactive protein,CRP)在小儿复杂性阑尾炎的诊断价值。方法2020年1月~2021年12月期间就诊于我院的小儿急性阑尾炎手术病人220例,其中观察组120例,为复杂性阑尾炎,对照组100例,为单纯性阑尾炎。比较两组病人性别、年龄、NLR、WBC、CRP的差异;单因素分析筛选出复杂性阑尾炎的影响指标,Logistic回归分析筛选出复杂性阑尾炎的独立危险因素,然后采用受试者工作特征曲线(ROC)进行分析,预测NLR、WBC、CRP指标在小儿复杂性阑尾炎中的诊断价值。结果单因素分析发现,NLR、WBC、CRP是复杂性阑尾炎的影响因素;回归分析显示,NLR、WBC、CRP是复杂性阑尾炎的独立危险因素;进一步行ROC分析发现,NLR、WBC、CRP的曲线下面积(AUC)分别是0.843[95%CI:(0.791,0.894)]、0.766[95%CI:(0.704,0.827)]和0.699[95%CI:(0.631,0.767)];NLR联合WBC、NLR联合CRP、NLR联合WBC及CRP的AUC分别是0.869[95%CI:(0.823,0.915)]、0.888[95%CI:(0.846,0.930)]、0.902[95%CI:(0.863,0.941)]。结论NLR、WBC、CRP在诊断复杂性阑尾炎中有较好的预测价值。

Objective To investigate the diagnostic value of neutrophil lymphocyte ratio(NLR),white blood cell count(WBC)and C-reactive protein(CRP)in children with complex appendicitis.Methods Children with acute appendicitis who were treated in our Hospital from January 2020 to December 2021 were divided into complex appendicitis group(120 cases in used as the observation group)and simple appendicitis group(100 cases as the control group).The differences of gender,age,NLR,WBC and CRP between the two groups were compared.The influencing indexes of complex appendicitis were screened by univariate analysis,and the independent risk factors of complex appendicitis were screened by regression analysis.The receiver operating characteristic curve(ROC)was used to predict the diagnostic value of NLR,WBC and CRP indexes in children with complex appendicitis.Results Univariate analysis showed that NLR,WBC and CRP were the influencing factors of complex appendicitis;Multivariate analysis showed that NLR,WBC and CRP were independent risk factors for complex appendicitis.ROC analysis showed that the area under the curve(AUC)of NLR,WBC and CRP were 0.843[95%CI:(0.791,0.894)],0.766[95%CI:(0.704,0.827)],0.699[95%CI:(0.631,0.767)];The AUC of NLR combined WBC,NLR combined CRP,NLR combined WBC and CRP were 0.869[95%CI:(0.823,0.915)],0.888[95%CI:(0.846,0.930)],0.902[95%CI:(0.863,0.941)].Conclusion NLR,WBC and CRP have good predictive value in the diagnosis of complex appendicitis in children,and have important clinical reference significance.