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目的探讨白细胞计数(WBC)和C-反应蛋白(CRP)诊断急性阑尾炎(AA)的准确性是否与患者的症状持续时间有关。方法选取本院门诊和急诊877例疑似急性阑尾炎患者的资料。依据最终诊断分成AA组和非急性阑尾炎(NAA)组;再根据患者的症状持续时间分成<24 h组、24 h~48 h组、>48 h组。分别计算WBC>10×10~9/L、WBC>15×10~9/L、WBC为20×10~9/L,CRP>10 mg/L、CRP>50 mg/L、CRP>100 mg/L,WBC>10×10~9/L且CRP>10 mg/L、WBC>15×10~9/L且CRP>50 mg/L、WBC>20×10~9/L且CRP>100 mg/L诊断AA的敏感度、特异度、阳性预测值、阴性预测值。结果 WBC诊断AA的敏感度和阳性预测值最高的是24 h~48 h组,特异度相对较高的是<24 h组;CRP诊断敏感度最高的是>48 h组,特异度和阳性预测值较高的是<24 h组;CRP+WBC联合诊断时阳性预测值最高的是>48 h组。结论结合患者的症状持续时间时,WBC、CRP诊断AA的准确性没有提高。
Objective To investigate whether the accuracy of white blood cell count (WBC) and C-reactive protein (CRP) in diagnosing acute appendicitis (AA) is related to the duration of symptoms in patients. Methods The data of 877 patients with suspected acute appendicitis in our clinic and emergency department were selected. According to the final diagnosis, the patients were divided into AA group and non-acute appendicitis (NAA) group. According to the duration of symptoms, the patients were divided into <24 h group, 24 h to 48 h group and> 48 h group. The WBC> 10 × 10-9 / L, WBC> 15 × 10-9 / L, WBC 20 × 10-9 / L, CRP> 10 mg / L, CRP> 50 mg / / L, WBC> 10 × 10 ~ 9 / L and CRP> 10 mg / L, WBC> 15 × 10 ~ 9 / L and CRP> 50 mg / L, WBC> 20 × 10 ~ 9 / L and CRP> 100 mg / L diagnosis of AA sensitivity, specificity, positive predictive value, negative predictive value. Results The sensitivity and positive predictive values of WBC in diagnosing AA were highest between 24 h and 48 h and those with relatively high specificity were <24 h. The highest sensitivity and specificity of CRP in diagnosing AA were> 48 h, specificity and positive predictive value The higher value was <24 h group; the highest positive predictive value was CRP + WBC> 48 h group. Conclusion The accuracy of WBC and CRP diagnosis of AA did not improve when combined with the duration of symptoms.