目的 探讨血清C反应蛋白(C-reactive protein,CRP)及降钙素原(procalcitonin,PCT)对小儿急性阑尾炎诊断价值。方法 实验组选取96例武警兵团指挥部医院普外科确诊为急性阑尾炎的小儿患者,对照组选取同一时期来院体检的56名健康儿童,分别检测2组患者血清CRP、PCT、中性粒细胞比例(NEUT%)及白细胞计数(WBC)水平,并对实验组CRP和PCT的特异性、敏感性进行统计分析。结果 实验组血清CRP(27.73±6.77)mg/L、PCT(1.78±0.86)μg/L、NEUT%(80.63±10.35)%及WBC(14.20±3.21)×10⁹/L含量均显著高于对照组的(4.17±1.36 )mg/L、(0.43±0.76)μg/L、 (63.45±7.3)%、(9.07±3.59)×10⁹/L,两组比较差异具有统计学意义 (P<0.01);分型不同的阑尾炎组间血清CRP和PCT水平比较,差异有统计学意义(P<0.05);实验组患者血清CRP诊断敏感性、特异性分别为88.5%、71.9%,PCT的诊断敏感性、特异性分别为85.4%、90.6%,二者敏感性比较差异无统计学意义,但特异性比较差异有统计学意义 (P<0.01)。结论 血清CRP、PCT含量检测对诊断小儿急性阑尾炎有一定的临床价值,尤其是PCT水平对小儿急性阑尾炎诊断有较高的敏感性和特异性,更适合作为判断阑尾炎程度的辅助性诊断指标。

Objective To investigate the clinical applicability of serum CRP and PCT in the diagnosis of infantile acute appendicitis.Methods Ninety-six children diagnosed with acute appendicitis were recruited in the experimental group, while fifty-six healthy children who were subjected to a physical examination at the same time were selected in the control group.The levels of serum CRP, PCT, NEUT% and WBC were detected respectively. The specificityand sensitivity of PCT and CRP in the experimental group were statistically analyzed.Results The levels of serum CRP(27.73±6.77)mg/L,PCT(1.78±0.86)μg/L,NEUT%(80.63±10.35)% and WBC(14.20±3.21)×10⁹/L in the experimental group were significantly higher than those in the control group(4.17±1.36)mg/L,(0.43±0.76)μg/, (63.45±7.3)and(9.07±3.59)×10⁹/L respectively. The levels of serum CRP and PCT were significantly different between different groups of appendicitis(P<0.05). The sensitivity and specificity of CRP were 71.9% and 88.5% respectively, while those of PCT were 85.4% and 90.6% respectively. The difference in sensitivity was of no statistical significance, but the difference in specificity was(P<0.01).Conclusions The detection of serum CRP and PCT levels is of some clinical value in diagnosis of infantile acute appendicitis. As the PCT level has a high sensitivity and specificity, it can serve better as an auxiliary diagnostic indicator for appendicitis.