CRP in acute appendicitis--is it a necessary investigation?
CRP in acute appendicitis--is it a necessary investigation?
复制标题
DOI：
10.1016/s1743-9191(06)60050-2
复制
发表时间：
2004-01-01
期刊：
影响因子：
--
通讯作者：
Shankar, R
中科院分区：
文献类型：
--
作者：
Amalesh, T;Shankar, M;Shankar, R
背景：阑尾切除术是外科手术中最常见的手术之一。尽管采取了各种检查来提高诊断的准确性，但正常阑尾切除率仍然约为15-30%。许多研究都调查了 C 反应蛋白 (CRP) 在急性阑尾炎中的作用，但结果相互矛盾。 方法：在一项前瞻性双盲研究中，在前往手术室进行阑尾切除术之前，从 192 名儿童中采集术前血液，用于测量血清 C 反应蛋白。组织病理学分为阳性（急性阑尾炎）和阴性（正常阑尾），这与 CRP 值相关。结果：33 例阴性探查中有 14 例 CRP 正常（组织病理学正常阑尾）。血清CRP的特异性和敏感性分别为42%和91%。阳性（CRP 升高）和阴性（CRP 正常）测试的预测价值分别为 88% 和 48%。 结论：我们得出的结论是，CRP 值升高或正常都无助于诊断急性阑尾炎。 CRP 并不是帮助外科医生诊断阑尾炎的好工具，并且不应在疑似阑尾炎时测量 CRP。
BACKGROUND: Appendectomy is one of the commonest procedures in surgery. In spite of various investigations used to improve the accuracy of diagnosis, the rate of normal appendices removed is still about 15-30%. Many studies have investigated the role of C-reactive protein (CRP) in acute appendicitis, but with conflicting results.METHODS: In a prospective, double blind study, blood for the measurement of serum C-reactive protein was collected pre-operatively from 192 children before going to the operating theatre for appendectomy. The histopathology was grouped into positive (acute appendicitis) and negative (normal appendix) and this was correlated with CRP values.RESULTS: CRP was normal in 14 out of 33 negative explorations (normal appendix on histopathology). The specificity and sensitivity of serum CRP was 42% and 91% respectively. The predictive value of a positive (raised CRP) and negative (normal CRP) test is 88% and 48% respectively.CONCLUSION: We conclude that neither raised nor normal CRP value is helpful in the diagnosis of acute appendicitis. CRP is not a good tool for helping the surgeon make the diagnosis of appendicitis and it should not be measured in suspected appendicitis.