Daldal Emin, Dagmura Hasan
General Surgery, Gaziosmanpasa University, Kaleardı mahallesi, 60250 Tokat, Turkey.
General Surgery and Surgical Oncology Department, Gaziosmanpasa University, Kaleardı Mahallesi, 60250 Tokat, Turkey.
Healthcare (Basel). 2020 Feb 13;8(1):39. doi: 10.3390/healthcare8010039.
Acute appendicitis is one of the most common causes of acute abdominal diseases seen between the ages of 10 and 19, mostly seen in males. The lifetime risk of developing acute appendicitis is 8.6% for males and 6.7% for females. We aimed to investigate the efficacy of the complete blood count parameters, C-reactive protein, and Lymphocyte-C-reactive Protein Ratio laboratory tests in the diagnosis of acute appendicitis, as well as their relationship with appendix diameter. We retrospectively examined all patients who underwent appendectomy between 1 January 2012 and 30 June 2019 in the General Surgery Clinic of Gaziosmanpasa University Faculty of Medicine. Laboratory tests, imaging findings, age, and gender were recorded. Lymphoid hyperplasia is considered as normal appendix-in other words, as negative appendicitis. The distribution of Lymphoid hyperplasia and appendicitis rates were statistically different in the groups formed according to appendix diameter (≤6 and >6 mm) ( < 0.001). We found a significant correlation between appendix diameter and WBC (White blood count), Lymphocyte, Neutrophil, RDW(Red blood cell distribution width), NLR(Neutrophil to lymphocyte ratio), and PLT/L (Platelet to lymphocyte ratio), MPV (Mean platelet volume) and RDW were significantly different in patients with an appendix diameter of ≤6 mm ( = 0.007, = 0.006, respectively). WBC, Neutrophil, PDW, and NLR values were significantly different between appendicitis and hyperplasia groups in patients with an appendix diameter of >6 mm. The sensitivity of the NLR score (cutoff = 2.6057) in the diagnosis of appendicitis was 86.1% and selectivity was 50% in these patients. Complete blood count parameters evaluation with the clinical findings revealed that NLR is an important parameter that may help the diagnosis of acute appendicitis with an appendix diameter of >6 mm. In patients whose pathological results indicated acute appendicitis but who had a diameter of ≤6 mm, we found an elevated MPV and low RDW values.
急性阑尾炎是10至19岁人群中最常见的急性腹部疾病病因之一，多见于男性。男性患急性阑尾炎的终生风险为8.6%，女性为6.7%。我们旨在研究全血细胞计数参数、C反应蛋白和淋巴细胞-C反应蛋白比值实验室检查在急性阑尾炎诊断中的有效性，以及它们与阑尾直径的关系。我们回顾性研究了2012年1月1日至2019年6月30日在加济奥斯曼帕夏大学医学院普通外科门诊接受阑尾切除术的所有患者。记录实验室检查、影像学检查结果、年龄和性别。淋巴组织增生被视为正常阑尾——换句话说，为阴性阑尾炎。根据阑尾直径（≤6和>6 mm）分组，淋巴组织增生和阑尾炎发生率的分布在统计学上存在差异（<0.001）。我们发现阑尾直径与白细胞（WBC）、淋巴细胞、中性粒细胞、红细胞分布宽度（RDW）、中性粒细胞与淋巴细胞比值（NLR）以及血小板与淋巴细胞比值（PLT/L）之间存在显著相关性，阑尾直径≤6 mm的患者中平均血小板体积（MPV）和RDW有显著差异（分别为=0.007，=0.006）。阑尾直径>6 mm的患者中，阑尾炎组和增生组的WBC、中性粒细胞、血小板分布宽度（PDW）和NLR值有显著差异。在这些患者中，NLR评分（临界值=2.6057）诊断阑尾炎的敏感性为86.1%，特异性为50%。结合临床检查结果评估全血细胞计数参数发现，NLR是有助于诊断阑尾直径>6 mm的急性阑尾炎的重要参数。在病理结果显示为急性阑尾炎但阑尾直径≤6 mm的患者中，我们发现MPV升高和RDW值降低。
