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血常规参数在急诊科肾绞痛和急性阑尾炎鉴别诊断中的疗效。

The efficacy of hemogram parameters in the differential diagnosis of renal colic and acute appendicitis in the emergency department.

机构信息

Department of Emergency Medicine, Health Science University, Adana City Training and Research Hospital, Adana-Turkey.

Department of Internal Medicine, Health Science University, Adana City Training and Research Hospital, Adana-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2021 Jan;27(1):26-33. doi: 10.14744/tjtes.2020.69091.

Abstract

BACKGROUND

To investigate the efficacy of WBC, PLR and NLR for use in the differential diagnosis of acute appendicitis and renal colic in the emergency department.

METHODS

This study was conducted after consent was received from the Cukurova University Medicine Faculty Noninvasive Clinical Research Ethics Committee. In this study, 440 patients for whom file data could be accessed in the hospital automation and archive system who were admitted to the hospital with abdominal pain were included.

RESULTS

Of the 440 patients included in this study, 59.5% were male and 40.5% were female. The average age of the patients was 37.74±13.39 years. According to the pathological diagnosis, 207 patients were diagnosed with acute appendicitis. When the efficacy of differential diagnosis using hematological parameters was examined with ROC analysis, the neutrophil/lymphocyte ratio (NLR) value had the strongest predictive ability (AUC, 0.716, SS=0.024, 95% GA 0.668-0.764). After NLR, the platelet/lymphocyte ratio (PLR) value was the second-best concerning predictive ability for differential diagnosis (AUC, 0.608 SS=0.027, 95%, GA 0.555-0.661).

CONCLUSION

Patients with acute appendicitis and renal colic often present to the emergency department with abdominal pain. While patients with acute appendicitis are usually treated with surgical methods, medical treatment is used for renal colic in the acute period. The differential diagnosis of these two patient groups is important. We believe that the PLR and NLR values can be used when an exact differential diagnosis cannot be made.

摘要

背景

为了研究白细胞(WBC)、血小板/淋巴细胞比值(PLR)和中性粒细胞/淋巴细胞比值(NLR)在急诊科急性阑尾炎和肾绞痛鉴别诊断中的作用。

方法

本研究经库鲁瓦大学医学系非侵入性临床研究伦理委员会同意后进行。在这项研究中,纳入了在医院自动化和档案系统中可以获取病历数据的 440 名因腹痛入院的患者。

结果

本研究共纳入 440 例患者,其中 59.5%为男性,40.5%为女性。患者的平均年龄为 37.74±13.39 岁。根据病理诊断,207 例患者被诊断为急性阑尾炎。当使用 ROC 分析检查血液参数的鉴别诊断效果时,中性粒细胞/淋巴细胞比值(NLR)值具有最强的预测能力(AUC,0.716,SS=0.024,95%GA 0.668-0.764)。在 NLR 之后,血小板/淋巴细胞比值(PLR)值是鉴别诊断的第二好的预测能力(AUC,0.608,SS=0.027,95%GA 0.555-0.661)。

结论

患有急性阑尾炎和肾绞痛的患者常因腹痛就诊于急诊科。虽然急性阑尾炎患者通常采用手术方法治疗,但在急性期间采用药物治疗肾绞痛。对这两组患者进行鉴别诊断非常重要。我们认为,在无法进行明确鉴别诊断时,可以使用 PLR 和 NLR 值。

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