Serum and peritoneal inflammatory mediators in children with suspected acute appendicitis
Serum and peritoneal inflammatory mediators in children with suspected acute appendicitis
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DOI：
10.1001/archsurg.140.2.169
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发表时间：
2005-02-01
影响因子：
--
通讯作者：
Serour, F
中科院分区：
文献类型：
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作者：
Dalal, I;Somekh, E;Serour, F
假设：炎症标志物在阑尾炎受试者和对照组之间不同。与腹腔液相比，血清中的炎症标志物有所不同。在有阑尾炎的受试者中，炎症标志物在有穿孔和无穿孔的受试者之间存在差异。设计：横断面研究。地点：住院治疗。患者：24名接受阑尾切除术的儿童。A组(n=19)为阑尾炎组，N组(n=5)为正常阑尾组。主要观察指标：采用双抗体夹心酶联免疫吸附试验检测血清和腹膜IL-8、IL-10、粒细胞集落刺激因子、干扰素-γ细胞间黏附分子-1、基质金属蛋白酶-9、金属蛋白酶组织抑制因子-1的水平。白介素8(平均+/-SD，1416.8+/-1436pg/mLvs48+/-74.4pg/mL，P=.001)，IL-10(平均+/-SD，30855893 pg/mLvs 84.46pg/mL，P=0.02)，基质金属蛋白酶-9(平均+/-SD，1784+/-1225.1 ng/mLvs435+/-563 ng/mL，P=0.03)，和金属蛋白酶组织抑制物-1(Mean+/-SD，8939.2+/-7312.2 ng/mLvs 602.1+/-345.6 ng/mLP<；A组与N组比较差异有统计学意义(n=8)，穿孔组腹膜粒细胞集落刺激因子水平升高(平均+/-SD为4.3+/-14.4pg/mLvs62.7+/-79.2pg/mLP=0.02)。N组与A组之间血清金属蛋白酶组织抑制物-1水平差异无统计学意义，但N组与穿孔性阑尾炎患者之间差异有统计学意义(平均值+/-SD，205.9+/-43.8 ng/mLvs 3068.9+/-5122.4 ng/m L，P=0.05)。结论：目前，根据全身炎症反应标记物的检测来区分儿童人群中的阑尾炎和其他腹痛原因是不现实的。
Hypothesis: Inflammatory markers differ between subjects with appendicitis and controls. Markers of inflammation differ in serum compared with intraperitoneal fluid. Among subjects with appendicitis, inflammatory markers differ between subjects with and without perforation.Design: Cross-sectional.Setting: Hospitalized care.Patients: Twenty-four children who underwent an appendectomy. Group A (n = 19) consisted of patients with appendicitis and group N (n = 5) of patients with normal appendixes.Main Outcome Measures: Serum and peritoneal levels of interleukin (IL)8, IL-10, granulocyte colony-stimulating factor, interferon gamma soluble intercellular adhesion molecule-1, matrix metalloproteinase-9, and tissue inhibitor of metalloproteinases-1 were measured by enzyme-linked immunosorbent assay.Results: Age, sex, complete blood count, C-reactive protein level, and serum cytokines did not significantly differ by group. Peritoneal concentrations of interleukin-8 (mean +/-SD, 1416.8 +/- 1436 pg/mL vs 48 +/- 74.4 pg/mL, P = .001), IL-10 (mean +/-SD, 3085 5893 pg/mL vs 84 46 pg/mL, P = .02), matrix metalloproteinases-9 (mean +/-SD, 1784 +/- 1225.1 ng/mL vs 435 +/- 563 ng/mL, P = .03), and tissue inhibitor of metalloproteinases-1 (mean +/-SD, 8939.2 +/- 7312.2 ng/mL vs 602.1 +/- 345.6 ng/mL, P < .001) were significantly different in group A compared with group N. When compared by perforation (n = 8 with perforation vs n = I I without perforation), peritoneal granulocyte colony-stimulating factor levels were elevated in subjects with perforation (mean +/- SD, 4.3 +/- 14.4 pg/mL vs 62.7 +/- 79.2 pg/mL, P = .02). Although serum tissue inhibitor of metalloproteinases-1 was not different between groups N and A, it was significantly different between group N and patients with a perforated appendicitis (mean +/- SD, 205.9 +/- 43.8 ng/mL vs 3068.9 +/- 5122.4 ng/mL, P =. 04).Conclusion: Presently, it is not practical to differentiate appendicitis in a pediatric population from other causes of abdominal pain based on the detection of systemic inflammatory response markers.