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血清 I-FABP 水平在急性阑尾炎诊断中的价值。

The Value of Serum I-FABP Level in the Diagnosis of Acute Appendicitis.

出版信息

Clin Lab. 2022 May 1;68(5). doi: 10.7754/Clin.Lab.2021.210721.

DOI:10.7754/Clin.Lab.2021.210721
PMID:35536089
Abstract

BACKGROUND

Acute appendicitis is one of the most common abdominal emergencies worldwide. Biomarkers and imaging are valuable adjuncts to history and examination. Differentiating complicated and uncomplicated appendicitis is essential. Our aim is to investigate whether serum I-FABP could be a suitable diagnostic biomarker in diagnosing acute appendicitis in which inflammation and ischemia play a role in the pathophysiology.

METHODS

Sixty-six patients with histopathologically confirmed acute appendicitis were included in the study. Blood samples were taken from the patient and control groups to examine serum I-FABP, white blood cell (WBC) counts, C-reactive protein (CRP), and procalcitonin (PCT) levels.

RESULTS

Twenty-six patients (39.3%) had complicated appendicitis. When the patient and control groups were compared in terms of I-FABP, WBC, neutrophil-lymphocyte ratio, (NLR) CRP, and PCT values, a significant difference was found in all biochemical parameters (p < 0.001). We compared the levels of patients with uncomplicated and complicated appendicitis in terms of serum I-FABP, WBC, NLR, CRP, and PCT levels and found that only the I-FABP level was significantly different (p < 0.001), and the diagnostic sensitivity was higher in patients with complicated appendicitis compared with uncomplicated patients (AUC; 0.89 for I-FABP, 0.55, 0.57, 0.61, and 0.59 for WBC, NLR, CRP, and PCT respectively).

CONCLUSIONS

I-FABP has no diagnostic advantage over WBC, CRP, and PCT to diagnose acute appendicitis. However, it is more sensitive than other biomarkers in differentiating complicated from uncomplicated appendicitis.

摘要

背景

急性阑尾炎是全球最常见的腹部急症之一。生物标志物和影像学检查是病史和体格检查的重要补充。区分复杂型和单纯型阑尾炎至关重要。我们旨在研究血清 I-FABP 是否可作为一种合适的诊断生物标志物,用于诊断炎症和缺血在病理生理学中起作用的急性阑尾炎。

方法

本研究纳入了 66 例经组织病理学证实的急性阑尾炎患者。采集患者组和对照组的血样,以检测血清 I-FABP、白细胞(WBC)计数、C 反应蛋白(CRP)和降钙素原(PCT)水平。

结果

26 例患者(39.3%)患有复杂型阑尾炎。在患者组和对照组的 I-FABP、WBC、中性粒细胞-淋巴细胞比值(NLR)、CRP 和 PCT 值方面进行比较时,所有生化参数均存在显著差异(p < 0.001)。我们比较了单纯型和复杂型阑尾炎患者的血清 I-FABP、WBC、NLR、CRP 和 PCT 水平,发现只有 I-FABP 水平存在显著差异(p < 0.001),且复杂型阑尾炎患者的诊断敏感性高于单纯型阑尾炎患者(I-FABP 的 AUC 为 0.89,WBC、NLR、CRP 和 PCT 的 AUC 分别为 0.55、0.57、0.61 和 0.59)。

结论

I-FABP 在诊断急性阑尾炎方面与 WBC、CRP 和 PCT 相比无诊断优势。但在区分复杂型和单纯型阑尾炎方面,其敏感性优于其他生物标志物。

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