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目的探讨急性阑尾炎患者外周血presepsin水平在急性阑尾炎的诊断及病情评估中的价值。方法 2014年3月-2016年4月住院的78例急性阑尾炎患者,结合手术和或病理诊断结果分为单纯性阑尾炎组(4例)、化脓性阑尾炎组(46例)、坏疽性阑尾炎组(20例)、穿孔性阑尾炎组(8例),以30例健康志愿者为对照组。测定各组急性阑尾炎患者及对照组的血浆presepsin、PCT和CRP水平,并绘制ROC曲线评估3个指标在急性阑尾炎诊断中的价值。结果急性阑尾炎各亚组presepsin水平均明显高于正常对照组。化脓性阑尾炎组、坏疽性阑尾炎组及穿孔性阑尾炎组血PCT水平均高于单纯性阑尾炎组,化脓性阑尾炎组、坏疽性阑尾炎组及穿孔性阑尾炎组血CRP水平均高于单纯性阑尾炎组,差异均有统计学意义(P<0.05)。ROC分析显示,presepsin曲线下面积(85.2%)高于PCT(79.1%)及CRP(71.6%),presepsin诊断急性阑尾炎具有较高的灵敏度(75.5%)和特异度(88.2%)。结论血presepsin水平在急性阑尾炎患者中明显升高,较PCT及CRP更有诊断价值。
Objective To investigate the value of peripheral blood presepsin in acute appendicitis in the diagnosis and assessment of acute appendicitis. Methods A total of 78 patients with acute appendicitis hospitalized from March 2014 to April 2016 were divided into simple appendicitis group (n = 4), suppurative appendicitis group (n = 46), gangrenous appendicitis group (n = 20 cases), perforated appendicitis group (8 cases) and 30 healthy volunteers as control group. The levels of plasma presepsin, PCT and CRP in patients with acute appendicitis and control group were determined, and the ROC curve was drawn to evaluate the value of the three indicators in the diagnosis of acute appendicitis. Results The levels of presepsin in each subgroup of acute appendicitis were significantly higher than those in normal control group. The blood PCT levels in suppurative appendicitis group, gangrenous appendicitis group and perforation appendicitis group were higher than those in simple appendicitis group, suppurative appendicitis group, gangrenous appendicitis group and perforated appendicitis group were higher than simple appendicitis group, The differences were statistically significant (P <0.05). ROC analysis showed that the area under the curve of presepsin (85.2%) was higher than PCT (79.1%) and CRP (71.6%). Presepsin had higher sensitivity (75.5%) and specificity (88.2%) in the diagnosis of acute appendicitis. Conclusions The level of blood presepsin in patients with acute appendicitis was significantly higher than that of PCT and CRP.