IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis.
IL-6 Serum Levels Can Enhance the Diagnostic Power of Standard Blood Tests for Acute Appendicitis.
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DOI：
10.3390/children9101425
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发表时间：
2022-09-20
期刊：
影响因子：
2.4
通讯作者：
Lima, Mario
中科院分区：
文献类型：
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作者：
Di Mitri, Marco;Parente, Giovanni;Bonfiglioli, Giulia;Thomas, Eduje;Bisanti, Cristian;Cordola, Chiara;Vastano, Marzia;Cravano, Sara;Collautti, Edoardo;Di Carmine, Annalisa;D'Antonio, Simone;Gargano, Tommaso;Libri, Michele;Lima, Mario
背景：急性阑尾炎（AA）的诊断仍然具有挑战性，尤其是在儿科，因为早期症状并不特异，而且患者越年轻，解释就越困难。对于早期诊断以避免复杂性急性阑尾炎（CAA）及其后果的重要性，儿科外科医生之间存在很大程度的共识。本研究的目的是评估白细胞介素 6 (IL-6) 是否可以增强目前可用和常规执行的诊断工具对儿科患者疑似 AA 的敏感性 (Sn) 和特异性 (Sp)。材料和方法：进行了一项前瞻性观察性研究，纳入 2020 年 11 月至 2022 年 3 月期间接受阑尾切除术的患者。我们将患者分为三组：非发炎阑尾（NA 组）、非复杂性 AA（NCAA 组）和复杂性 AA（CAA 组）。我们比较了三组之间白细胞（WBC）、中性粒细胞、纤维蛋白原、铁蛋白、aPTT、INR、C反应蛋白（CRP）、IL-6和CRP的平均值。然后我们评估了单独和组合的 IL-6 和 CRP 的 Sn、Sp 和优势比 (OR)。结果：我们招募了 107 名接受 AA 手术的患者（NA 组 22 名，NCAA 组 63 名，CAA 组 21 名）。当比较 CAA 与 NA (p = 0.01) 以及 CAA 与 NCAA (p = 0.01) 时，CRP 水平显着增加，而 NA 和 NCAA 之间没有发现显着性差异 (p = 0.38)。将 NCAA 与 NA (p = 0.04)、CAA 与 NA (p = 0.04) 以及 CAA 与 NCAA (p = 0.02) 进行比较时，发现平均 IL-6 水平具有统计学意义的显着增加。单独考虑 CRP，区分 NA 和 AA（NCAA 和 CAA 一起）的 Sn、Sp 和 OR 分别为 86%、35% 和 33,17。类似地，单独使用 IL-6 的 Sn、Sp 和 OR 分别为 82%、54% 和 56。将 CRP 和 IL-6 血清水平结合在一起，Sn 急剧增加至 100%，Sp 为 40%，OR 为 77。 结论：我们的研究可能表明 IL-6 在早期 AA 检测中发挥重要作用，特别是与 CRP 联合使用时。
Background: The diagnosis of acute appendicitis (AA) remains challenging, especially in pediatrics, because early symptoms are not specific, and the younger the patient the more difficult their interpretation is. There is a large degree of agreement between pediatric surgeons on the importance of an early diagnosis to avoid complicated acute appendicitis (CAA) and its consequences. The aim of this study is to assess if Interleukin 6 (IL-6) could enhance the sensitivity (Sn) and specificity (Sp) of the currently available and routinely performed diagnostic tools in case of suspected AA in pediatric patients. Materials and Methods: A prospective observational study was conducted including patients who underwent appendectomy between November 2020 and March 2022. We divided patients into three groups: not inflamed appendix (group NA), not complicated AA (group NCAA), and complicated AA (group CAA). We compared the mean values of white blood cells (WBC), neutrophils, fibrinogen, ferritin, aPTT, INR, C-reactive protein (CRP), IL-6, and CRP between the three groups. Then we evaluated Sn, Sp, and odds ratio (OR) of IL-6 and CRP alone and combined. Results: We enrolled 107 patients operated on for AA (22 in Group NA, 63 in Group NCAA, and 21 in group CAA). CRP levels resulted in a significant increase when comparing CAA with NA (p = 0.01) and CAA with NCAA (p = 0.01), whereas no significance was found between NA and NCAA (p = 0.38). A statistically significant increase in average IL-6 levels was found when comparing NCAA with NA (p = 0.04), CAA with NA (p = 0.04), and CAA with NCAA (p = 0.02). Considering CRP alone, its Sn, Sp, and OR in distinguishing NA from AA (both NCAA and CAA together) are 86%, 35%, and 33,17, respectively. Similarly, Sn, Sp, and OR of IL-6 alone are 82%, 54%, and 56, respectively. Combining CRP and IL-6 serum levels together, the Sn increases drastically to 100% with an Sp of 40% and OR of 77. Conclusions: Our study may suggest an important role of IL-6 in the detection of AA in its early stage, especially when coupled with CRP.
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影响因子：
2.6
作者：
Andersson M;Kolodziej B;Andersson RE
通讯作者：
Andersson RE
影响因子：
1.7
作者：
Glass, Charity C.;Rangel, Shawn J.
通讯作者：
Rangel, Shawn J.
影响因子：
1.7
作者：
Morrow, Stephen E;Newman, Kurt D
通讯作者：
Newman, Kurt D
影响因子：
2
作者：
Pogorelic, Zenon;Luksic, Ana Marija;Balta, Vedran
通讯作者：
Balta, Vedran
可疑阑尾炎患者中白细胞总白细胞和中性粒细胞计数的临床价值：回顾性研究。
DOI：
10.1186/1749-7922-7-32
发表时间：
2012-10-02
期刊：
World journal of emergency surgery : WJES
影响因子：
--
作者：
Al-Gaithy ZK
通讯作者：
Al-Gaithy ZK