Clinical value of total white blood cells and neutrophil counts in patients with suspected appendicitis: retrospective study.
Clinical value of total white blood cells and neutrophil counts in patients with suspected appendicitis: retrospective study.
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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
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发表时间：
2012-10-02
期刊：
影响因子：
--
通讯作者：
Al-Gaithy ZK
中科院分区：
文献类型：
--
作者：
Al-Gaithy ZK
急性阑尾炎（AA）是常见的外科问题与急性期反应。血液测试在决策过程中的作用尚不清楚。本回顾性研究旨在确定术前评估白色血细胞（WBC）和中性粒细胞的诊断价值及其在预测AA严重程度方面的价值。回顾性分析4年间456例阑尾切除术患者的临床资料。根据组织学检查结果将患者分为：正常阑尾（n = 29），单纯性阑尾炎（n = 350），复杂性阑尾炎（n = 77）。使用受试者工作特征（ROC）曲线分析WBC和中性粒细胞的诊断性能。白细胞和中性粒细胞计数在炎症和复杂的阑尾患者高于正常阑尾，复杂的阑尾比炎症。在患者中，WBC计数9.400 × 103/mL的敏感性为76.81%，特异性为65.52%，阳性预测值（PPV）为97.0%，阴性预测值（NPV）为16.1%，阳性似然比[LR（+）]为2.23，阴性LR（-）为0.35。中性粒细胞计数7.540 × 103/mL的敏感性为70.96%，特异性为65.52%，PPV为96.8%，NPV为13.3%，LR（+）为2.06，LR（-）为0.44。白细胞计数和中性粒细胞计数升高的ROC曲线下面积分别为0.701、0.680。临床医生不应依赖白细胞或中性粒细胞计数升高作为阑尾炎的指标，因为临床数据在阑尾切除术的决策中具有上级优势。
Acute appendicitis (AA) is common surgical problem associated with acute-phase reaction. Blood tests role in decision-making process is unclear. This retrospective study aimed to determine diagnostic value of preoperative evaluation of white blood cells (WBCs) and neutrophils and its value in predicting AA severity. Medical records of 456 patients who underwent appendectomy during 4-years period were retrospectively reviewed. Patients were subdivided according to histological finding into: normal appendix (n = 29), uncomplicated inflamed appendix (n = 350), complicated appendicitis (n = 77). Diagnostic performances of WBCs and neutrophils were analyzed using receiver operating characteristic (ROC) curves. WBCs and neutrophils counts were higher in patients with inflamed and complicated appendix than normal appendix and in complicated than inflamed appendix. In patients, WBCs count 9.400 × 103/mL had sensitivity of 76.81%, specificity of 65.52%, positive predictive value (PPV) of 97.0%, negative predictive value (NPV) of 16.1%, positive likelihood ratio [LR(+)] of 2.23, negative LR(−) of 0.35. Neutrophil count 7.540 × 103/mL had sensitivity of 70.96%, specificity of 65.52%, PPV of 96.8%, NPV of 13.3%, LR(+) of 2.06, LR(−) of 0.44. Areas under ROC curve were 0.701, 0.680 for elevated WBCs and neutrophils count. Clinicians should not rely on either elevated WBCs or neutrophils count as appendicitis indicator as clinical data are superior in decision-making appendectomy.
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影响因子：
2.6
作者：
Andersson, RE;Hugander, AP;Olaison, GP
通讯作者：
Olaison, GP
影响因子：
--
作者：
Dalal, I;Somekh, E;Serour, F
通讯作者：
Serour, F
影响因子：
9.6
作者：
Andersson, REB
通讯作者：
Andersson, REB
影响因子：
--
作者：
Lee, SL;Walsh, AJ;Ho, HS
通讯作者：
Ho, HS
影响因子：
3.8
作者：
Grönroos, JM
通讯作者：
Grönroos, JM