血清降钙素原 D-二聚体 白细胞计数联合C反应蛋白测定在阑尾炎中的诊断价值

The clinical value of serum procalcitonin, D-dimer, white blood cell count combined with C-reactive protein in diagnosis and treatment of appendicitis

目的 调查血清降钙素原(PCT)、D-二聚体(D-D)、白细胞计数(WBC)联合C反应蛋白(CRP)水平在阑尾炎诊断中的应用价值。方法 2020年1月至2022年12月,我院收治100例阑尾炎患者,将其做研究组,结合患者手术及术后标本的病理检验结果诊断,研究组患者又分为单纯性阑尾炎22例、阑尾周围脓肿25例、坏疽性阑尾炎及穿孔23例、急性化脓性阑尾炎30例。同时在本院同期住院的疑似阑尾炎患者中选取40例作为对照组。比较对照组与研究组血清PCT、D-D、CRP、外周血WBC水平;比较研究组中各个疾病组患者的血清PCT、D-D、CRP、外周血WBC水平;分析外周血WBC、血清CRP检测的诊断效能:以手术和病理结果为金标准,计算对照组和研究组阳性率及检测效能指标。结果 研究组血清PCT、D-D、CRP、外周血WBC水平均高于对照组;研究组中4组的血清PCT、D-D、CRP水平:坏疽性阑尾炎及穿孔组均高于另外3组(P<0.05),研究组中4组的外周血WBC水平差异无统计学意义(P>0.05)。外周血WBC、血清CRP诊断急性阑尾炎的灵敏度分别为73.7%、63.3%,准确度分别为67.0%、86.4%,特异度分别为87.6%、93.5%。结论血清PCT、D-D、WBC结合CRP在阑尾炎患者中水平更高,血清PCT、D-D、CRP水平检测有助于急性阑尾炎的病理分型鉴别。

Objective To investigate the clinical value of serum PCT,D-D,WBC combined with CRP in diagnosis and treatment of appendicitis.Methods From January 2020 to December 2022,100 patients were treated in our hospital,and they were selected as the study group.Combined with the diagnosis results of surgery and pathological examination of postoperative specimens,the patients in the study group were further divided into 22 cases of simple appendicitis,25 cases of periappendiceal abscess,23 cases of gangrenous appendicitis and perforation,and 30 cases of acute suppurative appendicitis.And included into various groups.At the same time,40 cases of suspected appendicitis hospitalized in our hospital were selected as the control group.The levels of serum PCT,D-D,CRP and peripheral blood WBC in control group and study group were investigated.To investigate the levels of serum PCT,D-D,CRP and peripheral blood WBC in patients with different disease groups in the study group;To investigate the diagnostic efficacy of WBC in peripheral blood and CRP in serum:with surgical and pathological results as the gold standard,the positive rate of the control group and the study group were calculated,and the detection efficacy index was calculated.Results The levels of serum PCT,D-D,CRP and WBC in the study group were higher than those in the control group.The levels of serum PCT,D-D and CRP of the four groups in the study group were compared:gangrenous appendicitis and perforation group were higher than those of the other three groups(P<0.05).There was no significant difference in WBC levels in the four groups(P>0.05).The sensitivity,accuracy and specificity of peripheral blood WBC and serum CRP in the diagnosis of acute appendicitis were 73.7%and 63.3%,67.0%and 86.4%,respectively,and 87.6%and 93.5%,respectively.Conclusion Serum PCT,D-D,WBC combined with CRP levels are higher in patients with appendicitis,and detection of serum PCT,D-D,CRP levels is helpful for pathologic differentiation of acute appendicitis.