白细胞计数不能提高诊断评分（DS）鉴别急性阑尾炎（AA）与非特异性腹痛（NSAP）的诊断性能。
Leucocyte Count Does Not Improve the Diagnostic Performance of a Diagnostic Score (DS) in Distinguishing Acute Appendicitis (AA) from Nonspecific Abdominal Pain (NSAP).
机构信息
Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.
出版信息
In Vivo. 2020 Nov-Dec;34(6):3327-3339. doi: 10.21873/invivo.12171.
BACKGROUND/AIM: Although, acute appendicitis (AA) and nonspecific abdominal pain (NSAP) are the most common diagnoses among secondary care patients with acute abdominal pain, the diagnostic performance of leucocyte count (LC) in DS (Diagnostic Score) model is rarely considered.
PATIENTS AND METHODS
As an extension of the World Organisation of Gastro-Enterology Research Committee (OMGE) acute abdominal pain study, 1,333 patients presenting with acute abdominal pain were included in the study. The clinical history and diagnostic symptoms (n=22), signs (n=14) and tests (n=3) in each patient were recorded in detail, and the collected data were related with the final diagnoses of the patients.
RESULTS
In the ROC comparison test, there was no statistically significant difference in the performance of DS (DS without LC) and DS (DS with LC). The highest sensitivities of the DS and DS tests for detecting AA were 86% (95%CI=81-90%) and 87% (95%CI=82-91%), respectively. The highest specificities of the DS and DS tests for detecting AA were 98% (95%CI=97-99%) and 98% (95%CI=96-99%), respectively.
CONCLUSION
DS could assist the clinician in differentiating AA from NSAP and other causes of acute abdominal pain. Importantly, LC does not improve the diagnostic performance of a DS in AA.
背景/目的：尽管急性阑尾炎（AA）和非特异性腹痛（NSAP）是二级保健患者急性腹痛最常见的诊断，但 DS（诊断评分）模型中白细胞计数（LC）的诊断性能很少被考虑。
患者和方法
作为世界胃肠病学组织研究委员会（OMGE）急性腹痛研究的扩展，纳入了 1333 名患有急性腹痛的患者。详细记录每位患者的临床病史和诊断症状（n=22）、体征（n=14）和检查（n=3），并将收集的数据与患者的最终诊断相关联。
结果
在 ROC 比较测试中，DS（无 LC 的 DS）和 DS（有 LC 的 DS）的性能没有统计学差异。DS 和 DS 检查检测 AA 的最高敏感度分别为 86%（95%CI=81-90%）和 87%（95%CI=82-91%）。DS 和 DS 检查检测 AA 的最高特异性分别为 98%（95%CI=97-99%）和 98%（95%CI=96-99%）。
结论
DS 可以帮助临床医生区分 AA 与 NSAP 和其他急性腹痛的原因。重要的是，LC 不会提高 DS 在 AA 中的诊断性能。
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