| 欧阳骏骏,蔡宝,徐冰.儿童急性阑尾炎复杂程度的危险因素初步研究[J].安徽医药,2026,30(3):572-576. |
| 儿童急性阑尾炎复杂程度的危险因素初步研究 |
| A preliminary study on the risk factors for the complexity of acute appendicitis in children |
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| DOI：10.3969/j.issn.1009-6469.2026.03.028 |
| 中文关键词: 阑尾炎 复杂程度 血小板 白蛋白 危险因素 儿童 |
| 英文关键词: Appendicitis Complexity level Platelets Albumin Risk factors Children |
| 基金项目:安徽医科大学校科研基金项目( 2018xkj078) |
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| 中文摘要: |
| 目的探讨儿童急性阑尾炎复杂程度的危险因素。方法回顾性收集 2021年 9月至 2023年 9月安庆市立医院收治的 101例术前诊断为急性阑尾炎的病儿，且均急诊行腹腔镜下阑尾切除术，依据术中探查所见及术后病理结论，将其分为非复杂性阑尾炎组( 53例)和复杂性阑尾炎组( 48例)。单因素 logistic回归比较两组临床资料，将差异有统计意义的指标纳入多因素 logistic分析，获得儿童急性复杂性阑尾炎的独立危险因素，利用受试者操作特征曲线( ROC曲线)对独立危险因素进行分析，评估各危险因素预测复杂性阑尾炎的价值。结果单因素 logistic分析结果显示，非复杂性阑尾炎组碱性磷酸酶( ALP)、白蛋白及淋巴细胞水平高于复杂性阑尾炎组( P<0.05)白细胞、 C反应蛋白( CRP)、中性粒细胞( NEUT)、白细胞 /ALP、NEUT/白细胞 /白蛋白、 NEUT/ALP及 NEUT/白蛋白水平低于复，杂性阑尾炎组( P<0.05)，血小板［249.00(208.00，283.00)×109/L比 297.50(258.50，357.25)×109/L］、 CRP/ALP［2.83%(0.73%，10.24%)比 64.45%(23.71%，120.06%)］、白细胞 /白蛋白［22.80%(13.42%，28.77%)比 37.60%(29.42%，47.71%)］也小于复杂性阑尾炎组( P<0.05)；多因素 logistic分析结果显示，血小板［OR=1.01， 95%CI:(1.00，1.02)］、 CRP/AL［OR=1.05，95%CI:(1.03，1.08)］、白细胞 /白蛋白［OR=1.11，95%CI:(1.04，1.19)］为儿童复杂性阑尾炎的独立危险因素。 ROC曲线分析得出 CRP/ALP预测儿童急性阑尾炎复杂程度的曲线下面积( AUC)及其 95%CI为 0.90(0.84，0.96)当 CRP/ALP>18.71%时，约登指数最大为 0.70，灵敏度和特异度分别为 87.50%和 83.00%；血小板、白细胞 /白蛋白及以上指标合预测的 AUC及其 95%CI分别为 0.75(0.66，0.85)、 0.83(0.76，0.91)、 0.95(0.91，0.99)。结论血小板、白细胞 /白蛋白与 CRP/ALP均为儿童急性复杂性阑尾炎的独立危险因素，且 CRP/ALP>18.71%时诊断为复杂性阑尾炎的风险明显升高，联，三者联合诊断的效能更高，这将有助于指导儿童急性阑尾炎的治疗。 |
| 英文摘要: |
| Objective To investigate the risk factors for the complexity of acute appendicitis in children.Methods Retrospectiveanalysis was performed with the clinical data of 101 children with acute appendicitis who underwent laparoscopic appendectomy andwere diagnosed by pathology in Anqing Municipal Hospital from September 2021 to September 2023. According to the intraoperativefindings and the result of postoperative pathology, the children with acute appendicitis were assigned into uncomplicated appendicitisgroup (n=53) or complicated appendicitis group (n=48). Univariate logistic regression was used to compare the clinical data between thetwo groups, and the indicators with statistically significant differences were included in the multivariate logistic analysis to obtain theindependent risk factors for complicated appendicitis. The factors were analyzed using the receiver operating characteristic curve (ROCcurve), and the value of each risk factor was evaluated in predicting complicated appendicitis.Results Univariate logistic regressionanalysis results showed that the alkaline phosphatase (ALP), albumin and lymphocyte levels in the uncomplicated appendicitis groupwere higher than those in the complicated appendicitis group (P<0.05), while white blood cells, C-reactive protein (CRP), neutrophils(NEUT), white blood cell/ALP, NEUT/white blood cell/albumin, NEUT/ALP, and NEUT/albumin in uncomplicated appendicitis groupwere lower than those in complicated appendicitis group (P<0.05), and platelets [249.00(208.00, 283.00) ×109/L vs. 297.50(258.50, 357.25) ×109/L], CRP/ALP [2.83%(0.73%, 10.24%) vs. 64.45%(23.71%, 120.06%)], and white blood cells/albumin [22.80%(13.42%, 28.77%) vs. 37.60%(29.42%,47.71%)] were also lower than those in complicated appendicitis group (P<0.05). Multivariate logistic re. gression analysis results showed that platelet [OR=1.01, 95%CI: (1.00,1.02)], CRP/ALP [OR=1.05, 95%CI: (1.03,1.08)], white blood cell/albumin [OR=1.11, 95%CI: (1.04,1.19)] were independent risk factors for complicated appendicitis in children. The ROC curveanalysis revealed that the area under the curve (AUC) and its 95%CI for CRP/ALP in predicting the complexity of acute appendicitis inchildren was 0.90 (0.84, 0.96);when CRP/ALP>18.71%, the youden index reached a maximum of 0.70, and the sensitivity and specifici. ty were 87.50% and 83.00%, respectively. The AUC and 95%CI of platelet, white blood cell/albumin and the combined prediction ofthe above indicators were 0.75 (0.66, 0.85), 0.83 (0.76, 0.91), and 0.95 (0.91, 0.99), respectively.Conclusions Platelet, white bloodcell/albumin and CRP/ALP are independent risk factors for complicated appendicitis in children, and the risk of complicated appendi.citis is significantly increased when CRP/ALP is greater than 18.71%. The combined diagnosis of the three indicators demonstratedhigher efficacy, which will help guide the treatment of acute appendicitis in children. |
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