Department of General Surgery, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Pol Przegl Chir. 2021 Oct 17;94(1):48-53. doi: 10.5604/01.3001.0015.3961.
Acute appendicitis is the most frequently encountered non-obstetric disease requiring surgical intervention during pregnancy. Early diagnosis reduces maternal and fetal morbidity / mortality rates.
This study aims to investigate hemogram parameters in the diagnosis of acute appendicitis in pregnant women.
A retrospective case-controlled study was conducted in three groups. Thirty-nine pregnant patients with acute appendicitis (Group A), 39 fertile nonpregnant patients with acute appendicitis (Group B), and 39 healthy pregnant women (Group C) were included in the study. WBC, neutrophil count, lymphocyte count, NLR, PLR, MPV and RDW values were compared.
The mean NLR values in group A, group B and group C were 7.39 (1.58-46.6), 5.66 (1-20) and 4.23 (1.54-10.77) respectively, and there was a significant difference in NLR values between the groups (P= 0.002). The mean PLR values in group A, group B and group C were 159.09 (69.1-574), 134.28 (21.5-360) and 120 (68.7-334) and difference was statistically significant (P= 0.019). Cutoff points for WBC count was 14155 106/μL (51,3% sensitivity, 82,1% specificity), for neutrophil count is 10955 106/μL (53,8% sensitivity, 84,6% specificity), for NLR is 9.23 (46,2% sensitivity, 92,3% specificity) and PLR is 157,6 (51,3% sensitivity and 82,1% specificity) NLR had largest area under the curve with 0.667 NLR.
Neutrophil count, WBC and PLR were found to be the most valuable inflammatory parameters however, RDW, Lymphocyte count, and MPV levels are not found valuable markers in terms of sensitivity and specificity in the diagnosis of acute appendicitis in pregnant patients by this study.
急性阑尾炎是孕期最常需要手术干预的非产科疾病。早期诊断可降低母婴发病率/死亡率。
本研究旨在探讨血常规参数在诊断孕妇急性阑尾炎中的价值。
回顾性病例对照研究纳入三组患者，共 39 例孕妇（A 组）、39 例非孕期生育力正常的急性阑尾炎患者（B 组）和 39 例健康孕妇（C 组）。比较 WBC、中性粒细胞计数、淋巴细胞计数、NLR、PLR、MPV 和 RDW 值。
A 组、B 组和 C 组的平均 NLR 值分别为 7.39（1.58-46.6）、5.66（1-20）和 4.23（1.54-10.77），组间 NLR 值差异有统计学意义（P=0.002）。A 组、B 组和 C 组的平均 PLR 值分别为 159.09（69.1-574）、134.28（21.5-360）和 120（68.7-334），差异有统计学意义（P=0.019）。WBC 计数的截断值为 14155 106/μL（51.3%的敏感性，82.1%的特异性），中性粒细胞计数的截断值为 10955 106/μL（53.8%的敏感性，84.6%的特异性），NLR 的截断值为 9.23（46.2%的敏感性，92.3%的特异性），PLR 的截断值为 157.6（51.3%的敏感性，82.1%的特异性）。NLR 的 AUC 最大，为 0.667。
中性粒细胞计数、WBC 和 PLR 是最有价值的炎症参数，但在本研究中，RDW、淋巴细胞计数和 MPV 水平在诊断孕妇急性阑尾炎的敏感性和特异性方面并不是有价值的标志物。
