I 型超敏反应特异性标志物联合 CRP 和 IL-6 在儿童复杂性急性阑尾炎中的诊断性能。

Diagnostic performance of type I hypersensitivity-specific markers combined with CRP and IL-6 in complicated acute appendicitis in pediatric patients.

机构信息

Department of General Surgery, Anhui Provincial Children's Hospital, Children's Hospital of Fudan University Anhui Hospital, Children's Hospital of Anhui Medical University, Hefei 230000, Anhui, China; The Fifth Clinical Medical College of Anhui Medical University, Hefei 230000, Anhui, China.

出版信息

Int Immunopharmacol. 2023 Nov;124(Pt B):110977. doi: 10.1016/j.intimp.2023.110977. Epub 2023 Sep 27.

DOI:10.1016/j.intimp.2023.110977

PMID:37774482

Abstract

OBJECTIVE

In this study, the diagnostic value of C-reactive protein (CRP), interleukin-6 (IL)-6, and specific markers for type I hypersensitivity were evaluated in pediatric patients with severe acute appendicitis.

METHODS

A total of 140 pediatric patients with "acute appendicitis" who underwent surgery at the Department of General Surgery of the Anhui Provincial Pediatric Patients' Hospital between December 2022 and April 2023 were studied retrospectively. The data collected included the gender, age, onset time, white blood cell count (WBC), CRP, procalcitonin (PCT), serum IgE, serum IL-4, serum IL-5, serum IL-6, serum IL-9, and serum IL-13 levels. The pediatric patients were divided into two groups based on the intraoperative situation and postoperative pathology: the non-complicated acute appendicitis group (NCAA) and the complicated acute appendicitis group (CAA). We analyzed the data from both groups using univariate and multivariate logistic regression models and constructed an ROC curve.

RESULTS

The CAA group outperformed the NCAA group in terms of onset time, WBC, CRP, PCT, IgE, IL-6, IL-9, and IL-13 levels (P < 0.05), but there was no statistically significant difference between the two groups in terms of gender, IL-4, or IL-5 levels (P > 0.05). Then, significant independent variables were incorporated into multivariate logistic regression. According to the results, CRP, IgE, IL-6, and IL-13 are all independent risk factors for CAA. The OR and 95% CI for each factor are as follows: CRP (OR = 1.073, 95%CI: 1.010-1.140, P = 0.022), IgE (OR = 0.975, 95%CI: 0.952-0.999, P = 0.038), IL-6 (OR = 1.494, 95%CI: 1.052-2.121, P = 0.025), and IL-13 (OR = 1.310, 95%CI: 1.036-1.657, P = 0.024). The receiving operator characteristics analysis yielded area under the curve (AUC) values of 0.8187, 0.9083, 0.8947, and 0.8394, respectively, for CRP, IgE, IL-6, and IL-13, confirming their significance in the diagnosis of CAA (P < 0.05).

CONCLUSION

Risk factors for CAA include CRP, IgE, IL-6, and IL-13. The combination of these serological markers can be used to diagnose CAA.

摘要

目的

本研究旨在评估 C 反应蛋白（CRP）、白细胞介素 6（IL-6）和 I 型超敏反应特异性标志物在儿科严重急性阑尾炎患者中的诊断价值。

方法

回顾性分析 2022 年 12 月至 2023 年 4 月在安徽省儿童医院普外科接受手术的 140 例“急性阑尾炎”儿科患者的临床资料。收集的资料包括性别、年龄、发病时间、白细胞计数（WBC）、CRP、降钙素原（PCT）、血清 IgE、血清 IL-4、血清 IL-5、血清 IL-6、血清 IL-9 和血清 IL-13 水平。根据术中情况和术后病理将患儿分为非复杂性急性阑尾炎组（NCAA）和复杂性急性阑尾炎组（CAA）。采用单因素和多因素 logistic 回归模型对两组数据进行分析，并绘制 ROC 曲线。

结果

CAA 组在发病时间、WBC、CRP、PCT、IgE、IL-6、IL-9 和 IL-13 水平方面优于 NCAA 组（P<0.05），但两组间性别、IL-4 或 IL-5 水平无统计学差异（P>0.05）。然后，将显著的独立变量纳入多因素 logistic 回归。结果表明，CRP、IgE、IL-6 和 IL-13 均为 CAA 的独立危险因素。各因素的 OR 和 95%CI 如下：CRP（OR=1.073，95%CI：1.010-1.140，P=0.022）、IgE（OR=0.975，95%CI：0.952-0.999，P=0.038）、IL-6（OR=1.494，95%CI：1.052-2.121，P=0.025）和 IL-13（OR=1.310，95%CI：1.036-1.657，P=0.024）。受试者工作特征分析得到 CRP、IgE、IL-6 和 IL-13 的曲线下面积（AUC）值分别为 0.8187、0.9083、0.8947 和 0.8394，表明它们在 CAA 诊断中具有重要意义（P<0.05）。