Reismann Josephine, Schädlich D, Minderjahn M I, Rothe K, Reismann M
Department of Pediatric Surgery, Charité, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Pediatr Surg Int. 2019 Mar;35(3):335-340. doi: 10.1007/s00383-018-4423-1. Epub 2018 Dec 7.
We have recently shown that uncomplicated phlegmonous appendicitis is characterized by independent inflammatory patterns based on significant eosinophilia in children aged 7-17 years. However, clinical decision-making based on inflammatory values is not easy, especially due to the dynamics of inflammation over time. The present study was performed to evaluate the basic distinguishability of the inflammatory entities by laboratory values over time based on an extended patient number with children aged 0-17 years.
All patients aged 0-17 years, who underwent appendectomy from January 2008 until June 2016, were retrospectively reviewed. Special attention was paid to cellular subpopulations within full blood counts within compartments of time (onset of symptoms - blood sampling): 0-12 , > 12-24 , > 24-36 , > 36-48 , > 48-72 , > 72 h.
1041 appendectomies were included in the study. The inflammatory course in patients with complicated appendicitis (n = 369) was characterized by continuously increased mean leukocytes, neutrophil and monocyte counts compared with patients with phlegmonous appendicitis (n = 489). In contrast, continuous relative eosinophilia was found in uncomplicated appendicitis within the inflammatory process. In cases of negative appendectomies (n = 183), again, distinct independent inflammatory patterns were found.
Eosinophilia is a constant and independent pattern in children with uncomplicated appendicitis, which, thus, can be distinguished throughout the inflammatory process.
我们最近发现，单纯性蜂窝织炎性阑尾炎在7至17岁儿童中表现为基于显著嗜酸性粒细胞增多的独立炎症模式。然而，基于炎症指标进行临床决策并非易事，尤其是考虑到炎症随时间的动态变化。本研究旨在基于更多0至17岁儿童患者，评估炎症指标随时间推移对炎症类型的基本区分能力。
回顾性分析2008年1月至2016年6月期间接受阑尾切除术的所有0至17岁患者。特别关注不同时间段（症状发作至采血）全血细胞计数中的细胞亚群：0至12小时、>12至24小时、>24至36小时、>36至48小时、>48至72小时、>72小时。
本研究纳入1041例阑尾切除术病例。与蜂窝织炎性阑尾炎患者（n = 489）相比，复杂性阑尾炎患者（n = 369）的炎症过程表现为平均白细胞、中性粒细胞和单核细胞计数持续增加。相比之下，单纯性阑尾炎在炎症过程中持续出现相对嗜酸性粒细胞增多。在阑尾切除阴性的病例（n = 183）中，同样发现了明显的独立炎症模式。
嗜酸性粒细胞增多是单纯性阑尾炎患儿恒定且独立的模式，因此在整个炎症过程中均可鉴别。
