- 期刊
Analysis of Inflammatory Parameters in Acute Appendicitis
發炎指數在急性闌尾炎之分析
摘要
背景 為了瞭解發炎指數在急性闌尾炎之臨床用途。 方法 從西元1999年1月至2000年12月在中國醫藥學院附設醫院因臨床上懷疑為急性闌尾炎的病人，總共526人，做了回顧性、探究性與橫斷式的研究。發炎指數包括：c-reactive protein，白血球總數與嗜中性白血球比例。統計方法採用t檢定，卡方檢定與多變項羅吉斯迴歸分析。 結果 急性闌尾炎的正確診斷率為85%。如果c-reactive protein，白血球總數與嗜中性白血球比例皆升高時，診斷急性闌尾炎的特異性與陽性預測值會提高，但敏感度會降低。在控制其他變項之後，以多變項羅吉斯迴歸分析來看，急性闌尾炎的相關因子為男性與偏高的嗜中性白血球比例。 結論 當臨床上懷疑急性闌尾炎時，如果嗜中性白血球比例也偏高的話，則急性闌尾炎的診斷率將提高。另外，我們建議將c-reactive protein，白血球總數與嗜中性白血球的比例列入常規檢查。
並列摘要
Background. The aim of this study was to compare the usefulness of the inflammatory parameters in diagnosing acute appendicitis in primary healthcare settings and emergency departments. Methods. This was a retrospective, exploratory, cross-sectional study. We analyzed526 patients suspected of having acute appendicitis. The primary factors studied were c-reactive protein levels, white blood cell counts and neutrophil ratios. The t test, chi-square test and multivariate logistic regression were used for statistical analysis of the primary factors. Results. The accurate diagnostic rate of acute appendicitis was 85%. When elevated levels of c-reactive protein, leukocytosis and elevated neutrophil ratios were used together, specificity and positive predictive values for diagnosing acute appendicitis increased, but sensitivity decreased. After controlling the other covariates, multivariate logistic regression analysis showed that the significant related factors of acute appendicitis were gender (male) (odds ratio = 2.6,95% confidence interval=1.6-4.4, p ＜ 0.001) and elevated neutrophil ratios (odds ratio = 3.3, 95% confidence interval=2.0－5.7, p＜ 0.001). Conclusions. Accurate diagnosis of acute appendicitis increases for patients with clinically suspected acute appendicitis if elevated neutrophil ratios are observed. We also recommend measuring c-reactive protein levels, white blood cell counts and neutrophil ratios as routine laboratory tests for diagnosing acute appendicitis.