外周血MPV结合超声与TWIST评分系统在儿童睾丸扭转诊断评估中的应用

Application of peripheral blood MPV combined with ultrasound and TWIST scoring system for diagnostic evaluation of testicular torsion in children

目的探究外周血平均血小板体积(MPV)结合超声与睾丸扭转评分(TWIST)系统在儿童睾丸扭转诊断评估中的应用。方法回顾性纳入2019年12月至2022年12月在安徽省儿童医院就诊的104例急性阴囊疼痛患儿,其中54例睾丸扭转儿童作为研究组,50例非扭转患儿作为对照组。两组患儿均进行超声检查,检测患儿血清红细胞分布宽度(RDW-CV)、红细胞平均血红蛋白浓度(MCHC)及外周血MPV水平,并比较两组患儿的TWIST评分,并采用受试者工作特征(ROC)曲线探究MPV联合超声及TWIST评分对儿童睾丸扭转的诊断价值。结果两组间RDW-CV、MCHC比较,差异均无统计学意义(P>0.05),研究组的MPV水平为(9.91±0.98)fL,高于对照组[(8.31±0.87)fL],差异有统计学意义(P<0.05)。两组Arda评分分级间比较差异有统计学意义(P<0.05),研究组分级为3级占比更高。两组间健侧睾丸体积比较,差异无统计学意义(P>0.05);研究组患侧睾丸体积及患健侧体积比分别为(2.77±1.03)mL、1.77±0.98,均高于对照组[(2.13±0.89)mL、1.39±0.89],差异均有统计学意义(P<0.05)。两组TWIST评分分级间存在差异,与对照组相比较,研究组高评分患儿占比更高,差异有统计学意义(P<0.05)。采用ROC曲线探究TWIST评分系统、MPV、超声参数及TWIST评分、MPV联合Arda评分对儿童睾丸扭转的诊断价值,其曲线下面积(AUC)值分别为0.884、0.882、0.674、0.614、0.710、0.981,TWIST评分、MPV联合Arda评分对儿童睾丸扭转的诊断AUC值高于单独一项指标诊断,具有较高的诊断价值。结论外周血MPV结合超声与TWIST评分系统联合应用诊断儿童睾丸扭转的价值高于其单独应用,诊断价值较高,值得临床推广。

Objective To explore the application of the mean peripheral blood platelet volume(MPV)combined with ultrasound and testicular work-up for ischemia and suspected torsion(TWIST)system in the diagnostic evaluation of testicular torsion in children.Methods A total of 104 children with acute scrotal pain treated in Anhui Children's Hospital from December 2019 to December 2022 were retrospectively included,of which 54 children with testicular torsion were included in the study group and 50 children with non-torsion were included in the control group.The children in both groups underwent ultrasound examination to detect the serum red blood cell distribution width(RDW-CV),mean red blood cell hemoglobin concentration(MCHC)and peripheral blood MPV level of the children,and compared the TWIST score of the children in the two groups,and the diagnostic value of MPV combined with ultrasound and TWIST score in children's testicular torsion was explored by receiver operating characteristic(ROC)curve.Results There was no statistically significant difference between RDW-CV and MCHC groups(P>0.05),and the MPV level in the study group was(9.91±0.98)fL,which was higher than that in the control group[(8.31±0.87)fL],the difference was statistically significant(P<0.05).There was statistically significant difference in Arda scores between the two groups(P<0.05),and the higher proportion of grade 3 was found in the study group.There was no statistically significant difference in healthy side testicular volumes between the two groups(P>0.05);the volume of the affected testicles and the volume ratio of the healthy side in the study group were(2.77±1.03)mL and 1.77±0.98,respectively,which were higher than those in the control group[(2.13±0.89)mL and 1.39±0.89],the differences were statistically significant(P<0.05).There were differences between the TWIST scores between the two groups,with the proportion of patients with higher scores in the study group compared with the control group,the difference was statistically significant(P<0.05).ROC curve was used to explore the diagnostic value of MPV,ultrasound,TWIST scoring system and TWIST score,and MPV combined with Arda score testicular torsion in children,and the area under the curve(AUC)values were 0.884,0.882,0.674,0.614,0.710 and 0.981,respectively.The diagnostic AUC value of TWIST score,and MPV combined with Arda score testicular torsion in children was higher than that of children,which had high diagnostic value.Conclusion The combined application of peripheral blood MPV combined with ultrasound and TWIST scoring system to diagnose testicular torsion in children has a higher value than its separate application,and its high diagnostic value is worthy of clinical promotion.