Diagnostic value of blood inflammatory markers for detection of acute appendicitis in children
Diagnostic value of blood inflammatory markers for detection of acute appendicitis in children
复制标题
血液炎症标志物对儿童急性阑尾炎的诊断价值
作者：
Ulrich Sack;Birgit Biereder;Tino Elouahidi;Katrin Bauer;Thomas Keller;Ralf
研究背景急性阑尾炎（AA）是一种常见的外科问题，与急性期反应有关。先前的研究表明，细胞因子和急性期蛋白被激活，并可能作为阑尾炎严重程度的指标。本研究的目的是比较不同的血清炎症标志物的诊断价值，在检测阑尾炎或穿孔的children.MethodsData前瞻性地收集了211个连续的儿童。对189例疑似AA的患者进行了剖腹手术。入院时检测白色细胞计数（WBC）、C反应蛋白（CRP）、白细胞介素6（IL 6）、肿瘤坏死因子α（TNF α）、酸性α1糖蛋白（α1GP）、内毒素及血沉（ESR）。应用受试者工作特征（ROC）currences.ResultsWBC计数，CRP和IL-6的诊断性能进行了分析与严重程度的apoptoeal炎症。IL-6或CRP支持儿童重度阑尾炎的诊断，但WBC不支持。IL-6和CRP之间，有没有显着差异，在诊断use.ConclusionLaboratory结果应被认为是整合在临床评估。CRP和IL-6在外科医生判断是否需要紧急手术时同样可以提供补充信息。
BackgroundAcute appendicitis (AA) is a common surgical problem that is associated with an acute-phase reaction. Previous studies have shown that cytokines and acute-phase proteins are activated and may serve as indicators for the severity of appendicitis. The aim of this study was to compare diagnostic value of different serum inflammatory markers in detection of phlegmonous or perforated appendicitis in children.MethodsData were collected prospectively on 211 consecutive children. Laparotomy was performed for suspected AA for 189 patients. Patients were subdivided into groups: nonsurgical abdominal pain, early appendicitis, phlegmonous or gangrenous appendicitis, perforated appendicitis.White blood cell count (WBC), serum C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), acid α1-glycoprotein (α1GP), endotoxin, and erythrocyte sedimentation reaction (ESR) were estimated ad the time of admission. The diagnostic performance was analyzed using receiver operating characteristic (ROC) curves.ResultsWBC count, CRP and IL-6 correlated significantly with the severity of appendiceal inflammation. Identification of children with severe appendicitis was supported by IL-6 or CRP but not WBC. Between IL-6 and CRP, there were no significant differences in diagnostic use.ConclusionLaboratory results should be considered to be integrated within the clinical assessment. If used critically, CRP and IL-6 equally provide surgeons with complementary information in discerning the necessity for urgent operation.