PCT、PTX-3、NLR对急性阑尾炎严重程度的预测价值研究

Study on the Predictive Value of PCT,PTX-3 and NLR on the Severity of Acute Appendicitis

目的:探究降钙素原(procalcitonin,PCT)、正五聚体蛋白-3(pentraxin-3,PTX-3)、中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)对急性阑尾炎严重程度的预测价值。方法:回顾性选取2020年3月—2022年10月于抚州第五医院就诊的78例急性阑尾炎患者,根据其病情严重程度分为轻度组(n=66)和重度组(n=12),并选取同期50例健康体检者作为对照组。比较三组血清PTX-3、PCT、NLR,分析PCT、PTX-3、NLR与病情严重程度的相关性及其联合诊断重度急性阑尾炎的价值。结果:重度组与轻度组血清中性粒细胞(N)、超敏C反应蛋白(hs-CRP)水平均高于对照组,重度组血清N、hs-CRP水平均明显高于轻度组,差异均有统计学意义(P<0.05)。重度组与轻度组血清PCT、PTX-3、NLR均高于对照组,且重度组血清PCT、PTX-3、NLR均明显高于轻度组,差异均有统计学意义(P<0.05)。经Spearman相关性分析,PCT、PTX-3、NLR与急性阑尾炎病情严重程度间呈明显正相关(P<0.05)。建立受试者操作特征(ROC)曲线发现,PCT、PTX-3、NLR联合诊断重度急性阑尾炎的曲线下面积最大,且具有较高的敏感度及特异度。结论:随着急性阑尾炎患者病情的加重,PCT、PTX-3、NLR均明显升高,且上述指标在重度急性阑尾炎的诊断中具有较高价值。

Objective:To explore the predictive value of procalcitonin(PCT),pentraxin-3(PTX-3)and neutrophil/lymphocyte ratio(NLR)on the severity of acute appendicitis.Method:A total of 78 patients with acute appendicitis treated in Fuzhou Fifth Hospital from March 2020 to October 2022 were retrospectively selected,and divided into mild group(n=66)and severe group(n=12)according to the severity of their disease,and 50 healthy subjects were selected as control group during the same period.Serum PTX-3,PCT and NLR were compared among the three groups,the correlation between PCT,PTX-3,NLR and the severity of the disease and the value of combined diagnosis of severe acute appendicitis were analyze.Result:Serum neutrophil(N)and hypersensitive C reactive protein(hs-CRP)levels in severe group and mild group were higher than those in control group,and serum N and hs-CRP levels in severe group were significantly higher than those in mild group,the differences were statistically significant(P<0.05).Serum PCT,PTX-3 and NLR in severe group and mild group were higher than those in control group,and serum PCT,PTX-3 and NLR in severe group were significantly higher than those in mild group,the differences were statistically significant(P<0.05).By Spearman correlation analysis,PCT,PTX-3 and NLR were significantly positively correlated with the severity of acute appendicitis(P<0.05).Receiver operating characteristic(ROC)curve was established,and it was found that PCT,PTX-3 and NLR combined diagnosis of severe acute appendicitis had the largest area under the curve,and had high sensitivity and specificity.Conclusion:With the aggravation of acute appendicitis,PCT,PTX-3 and NLR are significantly increased,and the above indexes have high value in the diagnosis of severe acute appendicitis.