Do normal leucocyte count and C-reactive protein value exclude acute appendicitis in children?
Do normal leucocyte count and C-reactive protein value exclude acute appendicitis in children?
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DOI：
10.1080/08035250117900
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发表时间：
2001-06-01
期刊：
影响因子：
3.8
通讯作者：
Grönroos, JM
中科院分区：
文献类型：
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作者：
Grönroos, JM
本研究旨在确定白细胞计数和 C 反应蛋白 (CRP) 测量在儿童急性阑尾炎诊断中的作用。特别是患有急性阑尾炎但白细胞计数和 CRP 水平正常的儿童。本研究方案与早期对疑似急性阑尾炎成年患者的研究中使用的方案相同。计算连续 100 例阑尾切除术中阑尾未发炎的儿童（A 组）和连续 100 例急性阑尾炎患者（B 组）的术前平均白细胞计数和 CRP 值。在 A 组和 B 组中计算 (i) 两个值均正常、(ii) 仅白细胞计数升高、(iii) 仅 CRP 水平升高和 (iv) 两个值均升高的患者数量。白细胞计数有效 (p < 0.001) 将未发炎阑尾儿童 (平均值 +/- SEM 10.2 +/- 0.4 x 10(9) l(-1)) 与急性阑尾炎儿童 (15.0 +/- SEM) 区分开来。 0.4 x 10(9) l(-1))，但CRP值在这方面没有用处(p = 0.866；31 +/- 4 mg l(-1))和(30 +/- 4 mg l(-1))。最显着的发现是，在患有急性阑尾炎的儿童中，100名患者中有7名这两个值均正常。结论：与成人患者相反，白细胞计数和CRP值正常并不能有效排除儿童急性阑尾炎。
The present study aimed to determine the role of leucocyte count and C-reactive protein (CRP) measurements in the diagnosis of acute appendicitis in children. In particular, children with acute appendicitis but normal leucocyte count and CRP level were sought. The present study protocol was identical to those used in earlier studies on adult patients with suspected acute appendicitis. The mean preoperative leucocyte count and CRP value in 100 consecutive children with an uninflamed appendix at appendicectomy (group A) and in 100 consecutive patients with acute appendicitis (group B) were calculated. The numbers of patients with (i) both values normal, (ii) only leucocyte count raised, (iii) only CRP level raised, and (iv) both values raised were calculated in both groups A and B. Leucocyte count effectively (p < 0.001) separated children with uninflamed appendix (mean +/- SEM 10.2 +/- 0.4 x 10(9) l(-1)) from those with acute appendicitis (15.0 +/- 0.4 x 10(9) l(-1)), but the CRP value was of no use in this respect (p = 0.866; 31 +/- 4 mg l(-1)) and (30 +/- 4 mg l(-1)). The most conspicuous finding was that in children with acute appendicitis, both values were normal in 7 out of 100 patients.Conclusion: Contrary to adult patients, normal leucocyte count and CRP value do not effectively exclude acute appendicitis in children.