Aydin O U, Soylu L, Dandin O, Uysal Aydin E, Karademir S
Bratisl Lek Listy. 2016;117(12):697-701. doi: 10.4149/BLL_2016_132.
The purpose of the study was that monitoring, which is used in diagnosis of acute appendicitis, and laboratory values, were evaluated for verifying diagnosis of complicated appendicitis and these parameters revealed cut-off values in complicated acute/non-complicated appendicitis.
195 patients, who had had an operation for acute appendicitis between January 2012 and March 2015 and who were proved to have acute complicated/non-complicated appendicitis from the results of histopathology consideration, were included in this study. Patients' age, preoperative serum, WBC, CRP, NLR and BT with USG results were evaluated. RESULTS: Among the groups, there were no meaningful differences in the sense of age. Meaningful difference was obtained in between (p > 0.05), WBC, NLR, CRP and appendix diameter values.Serum in WBC >13800 (AUC = 0.614, p = 0.006, %95 GA: 0.541-0.682), in NLR > 4.87 (AUC = 0.641, p = 0.001, %95 GA: 0.569-0.708), in CRP > 5.98 (AUC = 0.651, p 11 mm (AUC = 0.630, p = 0.002, %95 GA: 0.558-0.698) values were obtained. The values that were obtained, were confirmed to be descriptive in analysis of complicated appendicitis and non-complicated appendicitis.According to the obtained cut-off values, serum WBC, diameter of appendicitis, NLR and CRP values', (OR) ratios were calculated for complicated appendicitis by being classified (odds ratio respectively; 3.103 (1.713-5.621), 2.765 (1.496-5.109), 3.025 (1.665-5.494), 2.313 (1.295-4.130)).
It is important that treatment options are evaluated to be able to discriminate complicated appendicitis fast and with a high accuracy. In the case that serum WBC is higher than 13800. CRP is higher than 5.98, NLR is higher than 4.87 and appendicitis diameter is longer than 11mm, inflammation of appendicitis is complex with gangrene, perforation and abscess and it emphasizes the suggestion of surgical treatment option to patients (Tab. 4, Fig. 1, Ref. 28).
本研究旨在评估用于急性阑尾炎诊断的监测手段及实验室检查值，以验证复杂性阑尾炎的诊断，并确定这些参数在复杂性急性/非复杂性阑尾炎中的临界值。
本研究纳入了195例在2012年1月至2015年3月期间因急性阑尾炎接受手术的患者，根据组织病理学结果证实为急性复杂性/非复杂性阑尾炎。评估了患者的年龄、术前血清、白细胞、C反应蛋白、中性粒细胞与淋巴细胞比值（NLR）以及超声检查结果。
两组患者在年龄方面无显著差异。白细胞、NLR、C反应蛋白及阑尾直径值之间存在显著差异（p>0.05）。白细胞>13800时血清（曲线下面积[AUC]=0.614，p=0.006，95%可信区间[GA]：0.541-0.682），NLR>4.87时（AUC=0.641，p=0.001，95%GA：0.569-0.708），C反应蛋白>5.98时（AUC=0.651，p<0.001，95%GA：0.578-0.715），阑尾直径>11mm时（AUC=0.630，p=0.002，95%GA：0.558-0.698）可获得相应临界值。所获得的值在复杂性阑尾炎和非复杂性阑尾炎分析中具有描述性。根据所获得的临界值，对复杂性阑尾炎进行分类计算血清白细胞、阑尾直径、NLR和C反应蛋白值的比值比（OR）（比值比分别为：3.103[1.713-5.621]，2.765[1.496-5.109]，3.025[1.665-5.494]，2.313[1.295-4.130]）。
能够快速且准确地区分复杂性阑尾炎的治疗方案评估非常重要。当血清白细胞高于13800、C反应蛋白高于5.98、NLR高于4.87且阑尾直径长于11mm时，阑尾炎炎症伴有坏疽、穿孔和脓肿，提示对患者采取手术治疗方案（表4，图1，参考文献28）。
