Eriksson S, Granström L, Olander B, Pira U
Department of Surgery, Karolinska Institute at Danderyd Hospital, Sweden.
Eur J Surg. 1995 Dec;161(12):901-5.
To investigate the value of measuring the activity of the leucocyte elastase complex in plasma in the diagnosis of acute appendicitis, either as a single or four-hourly test.
Open study.
Teaching hospital, Sweden.
165 consecutive patients admitted with suspected acute appendicitis.
Correlation of concentrations of leucocyte elastase complex (elastase) and total white blood cell count (WBC) with C-reactive protein concentration and histological appearance of the appendix.
Of 165 patients, 101 patients had their appendixes removed, and of these 86 had histologically confirmed appendicitis. An elastase value of less than 54 micrograms/l was considered to be the reference range. Elastase activity measured on admission gave a sensitivity of 61% and a specificity of 43% for acute appendicitis compared with the WBC which had a sensitivity of 81% and a specificity of 36%. The above blood tests were taken on two or more occasions four hourly after admission in 29 patients. Appendicitis was found in 25 of the 29 cases (87%), in which repeated tests showed a significant reduction in WBC together with a definite but not significant reduction in the elastase activity during the preoperative period. Repeated tests were of no value.
Measurement of the leucocyte elastase complex in plasma does not increase the accuracy of the diagnosis of acute appendicitis. There was no significant correlation between the leucocyte elastase activity and the total white cell count.
研究检测血浆中白细胞弹性蛋白酶复合物活性在急性阑尾炎诊断中的价值，无论是单次检测还是每四小时检测一次。
开放性研究。
瑞典的教学医院。
165例连续入院的疑似急性阑尾炎患者。
白细胞弹性蛋白酶复合物（弹性蛋白酶）浓度、白细胞总数（WBC）与C反应蛋白浓度及阑尾组织学表现的相关性。
165例患者中，101例行阑尾切除术，其中86例经组织学证实为阑尾炎。弹性蛋白酶值低于54微克/升被视为参考范围。入院时检测的弹性蛋白酶活性对急性阑尾炎的敏感性为61%，特异性为43%，而白细胞的敏感性为81%，特异性为36%。29例患者在入院后每四小时进行两次或更多次上述血液检测。29例中有25例（87%）发现阑尾炎，其中重复检测显示术前白细胞显著减少，弹性蛋白酶活性有一定但不显著的降低。重复检测无价值。
检测血浆中白细胞弹性蛋白酶复合物并不能提高急性阑尾炎诊断的准确性。白细胞弹性蛋白酶活性与白细胞总数之间无显著相关性。
