Gastrointestinal Lab, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, 3333 Bin Sheng Road, Hangzhou, 310052, Zhejiang, People's Republic of China.
Jinhua Hospital, Zhejiang University and Jinhua Municipal Central Hospital, Jinhua, Zhejiang, People's Republic of China.
Updates Surg. 2022 Oct;74(5):1683-1689. doi: 10.1007/s13304-022-01299-1. Epub 2022 Jun 23.
To explore the value of blood routine examination indexes in the differential diagnosis of immunoglobulin A vasculitis (IgAV) with abdominal involvement and appendicitis in children. Forty-seven patients with IgAV and abdominal involvement, 95 cases with appendicitis, and 48 healthy children were enrolled in this study. Demographic and laboratory data were retrospectively recorded from medical files. The levels of serum percentage of lymphocytes (LYM%), percentage of eosinophils (E%), red cell volume distribution width (RDW) and platelet (PLT) count were higher, while blood cells (WBC) count, percentage of neutrophils (N%), percentage of monocytes (M%), mean platelet volume (MPV), platelet distribution width and C-reactive protein were lower in the group of IgAV with abdominal involvement compared to appendicitis group (P < 0.05). Multivariate logistic regression analysis showed LYM% (odds ratio (OR) = 1.34, P = 0.001) and RDW (OR = 2.96, P = 0.045) were independent risk factors for IgAV with abdominal involvement. N% (OR = 1.270, P = 0.006) and MPV (OR = 51.15, P = 0.042) were independently associated with appendicitis. Using receiver operating characteristic analysis, the optimal cut-off values (sensitivity and specificity) respectively were 42.17% (95.7%, 100.0%) for LYM%, 12.65% (83.0%, 83.2%) for RDW, 61.5% (91.6%, 97.9%) for NE% and 10.1fL (78.9%, 75.4%) for MPV, with the AUC values of 0.989, 0.881, 0.985, 0.810, respectively. Blood routine examination indices, especially the N%, LYM%, RDW, and MPV, can be used for simple differential diagnosis of IgAV with abdominal involvement and appendicitis.
探讨血常规检查指标在儿童免疫球蛋白 A 血管炎（IgAV）伴腹部受累与阑尾炎鉴别诊断中的价值。本研究纳入 47 例 IgAV 伴腹部受累患儿、95 例阑尾炎患儿和 48 例健康儿童。回顾性记录病历中的人口统计学和实验室数据。IgAV 伴腹部受累组血清淋巴细胞百分比（LYM%）、嗜酸性粒细胞百分比（E%）、红细胞体积分布宽度（RDW）和血小板（PLT）计数较高，而白细胞（WBC）计数、中性粒细胞百分比（N%）、单核细胞百分比（M%）、血小板平均体积（MPV）、血小板分布宽度和 C 反应蛋白较低（P<0.05）。多变量 logistic 回归分析显示，LYM%（比值比（OR）=1.34，P=0.001）和 RDW（OR=2.96，P=0.045）是 IgAV 伴腹部受累的独立危险因素。N%（OR=1.270，P=0.006）和 MPV（OR=51.15，P=0.042）与阑尾炎独立相关。使用受试者工作特征分析，LYM%的最佳截断值（灵敏度和特异性）分别为 42.17%（95.7%，100.0%）、RDW 为 12.65%（83.0%，83.2%）、NE%为 61.5%（91.6%，97.9%）和 MPV 为 10.1fL（78.9%，75.4%），AUC 值分别为 0.989、0.881、0.985、0.810。血常规检查指标，尤其是 N%、LYM%、RDW 和 MPV，可用于简单鉴别诊断 IgAV 伴腹部受累与阑尾炎。
