Non-Communicable Pediatric Disease Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
The Clinical Research Development Unit of Amirkola Children's Hospital, Babol University of Medical Sciences, Babol, Iran.
Wien Med Wochenschr. 2022 Oct;172(13-14):303-307. doi: 10.1007/s10354-021-00898-8. Epub 2022 Jan 10.
Acute appendicitis (AA), the most common abdominal emergency disease, is one of the most important causes of hospitalization of children. Studies have shown that white blood cell (WBC) count, mean platelet volume (MPV), C‑reactive protein (CRP), and erythrocyte sedimentation rate (ESR) can play an important role in the diagnostic prediction of appendicitis. Therefore, the aim of this study was to evaluate the diagnostic value of WBC count, polymorphonuclear leukocytes (PMNs) percentage, MPV, CRP, and ESR for the diagnosis of AA.
In this study, 100 medical records were reviewed for children referred to the hospital complaining of abdominal pain and who underwent operation with a provisional diagnosis of acute appendicitis based on clinical and laboratory findings. Patients were divided into two groups according to the pathology gold standard method: AA and the other group with acute abdominal pain without appendicitis (AAP). The diagnostic accuracy of WBC, PMNs%, MPV, ESR, and CRP were compared for patients with AA and AAP.
A total of 100 patients (50 with AA and 50 with AAP) were identified. The sensitivity and specificity of WBC and PMNs% were 78 and 66%, and 76 and 54%, respectively; ESR was 80 and 48%, respectively; and CRP was 82 and 62% (30-89%), respectively. A low specificity (8%) and 70% sensitivity was calculated using the cutoff point of 8.1 fl for MPV.
Our data suggest that children with AA often present with significantly higher WBC count, ESR level, CRP level, PMNs%, and lower MPV level. The results of the study showed that WBC, CRP, and ESR, along with other diagnostic methods, can be useful in diagnosing AA in children. MPV is not effective in the diagnosis of AA due to its specificity; however, a significantly lower level was found in children with AA.
急性阑尾炎（AA）是最常见的腹部急症之一，也是儿童住院的最重要原因之一。研究表明，白细胞（WBC）计数、平均血小板体积（MPV）、C-反应蛋白（CRP）和红细胞沉降率（ESR）在阑尾炎的诊断预测中可以发挥重要作用。因此，本研究旨在评估 WBC 计数、中性粒细胞百分比、MPV、CRP 和 ESR 对 AA 诊断的诊断价值。
本研究回顾性分析了 100 例因腹痛就诊并经手术确诊为急性阑尾炎的患儿的病历，根据临床和实验室检查结果诊断为急性阑尾炎。根据病理金标准方法，将患者分为两组：AA 组和急性腹痛无阑尾炎（AAP）组。比较 AA 组和 AAP 组患者的 WBC、PMN%、MPV、ESR 和 CRP 的诊断准确性。
共纳入 100 例患者（50 例 AA 和 50 例 AAP）。WBC 和 PMNs%的敏感性和特异性分别为 78%和 66%、76%和 54%；ESR 分别为 80%和 48%；CRP 分别为 82%和 62%（30-89%）。MPV 的截断点为 8.1 fl 时，特异性较低（8%），敏感性为 70%。
我们的数据表明，AA 患儿常表现为白细胞计数、ESR 水平、CRP 水平、PMN%显著升高，MPV 水平显著降低。研究结果表明，WBC、CRP 和 ESR 与其他诊断方法一起可用于诊断儿童 AA。MPV 对 AA 的诊断无效，特异性低；然而，在 AA 患儿中发现其水平明显降低。
