Discriminant analysis of serum inflammatory biomarkers which differentiate pediatric appendicitis from other acute abdominal diseases.

K. Lin, Han-Ping Wu, Chin-Yi Huang, Ching‐Yuang Lin, Chin-Fu Chang
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引用次数: 9

Abstract

BACKGROUND Other acute abdominal diseases in children can confound the signs and symptoms of appendicitis, resulting in misdiagnosis and unnecessary appendectomy. In this study, we used discriminant analysis of serum inflammatory biomarkers to determine which acute abdominal diseases could mimic appendicitis, and further analyzed these diseases based on different age groups. METHODS We prospectively collected 417 patients aged from 4 to 18 years with clinically suspected acute appendicitis in the pediatric emergency department. We selected the significantly higher serum biomarkers for appendicitis as the discriminating variables. Furthermore, we analyzed the definitive diagnoses of patients with normal appendices who could not be predicted by discriminant analysis. RESULTS Patients with acute appendicitis had significantly higher leukocyte counts (p < 0.01), neutrophil counts, (p < 0.01) and C-reactive protein concentrations (p < 0.01 ) than those with normal appendices. The discriminant power of these three serum biomarkers in acute appendicitis was 76 percent. Acute abdominal diseases which mimicked appendicitis included acute gastroenteritis, nonspecific abdominal pain, urinary tract infection, and upper respiratory infection with gastrointestinal upset. CONCLUSIONS Serum biomarkers may serve as helpful discriminators to predict the presence of pediatric appendicitis. But, some acute abdominal diseases mimicking appendicitis should be considered during differential diagnosis of acute appendicitis to avoid making misdiagnosis and performing unnecessary appendectomy.
小儿阑尾炎与其他急性腹部疾病的血清炎症生物标志物鉴别分析。
背景其他儿童急性腹部疾病会混淆阑尾炎的症状和体征,导致误诊和不必要的阑尾切除术。在本研究中,我们使用血清炎症生物标志物判别分析来确定哪些急性腹部疾病可以模拟阑尾炎,并根据不同年龄组进一步分析这些疾病。方法前瞻性收集417例儿科急诊科临床疑似急性阑尾炎患者,年龄4 ~ 18岁。我们选择显著较高的阑尾炎血清生物标志物作为判别变量。此外,我们分析了无法通过判别分析预测的正常阑尾患者的明确诊断。结果急性阑尾炎患者白细胞计数(p < 0.01)、中性粒细胞计数(p < 0.01)和c反应蛋白浓度(p < 0.01)均显著高于阑尾正常患者。这三种血清生物标志物在急性阑尾炎中的鉴别能力为76%。模拟阑尾炎的急性腹部疾病包括急性胃肠炎、非特异性腹痛、尿路感染和上呼吸道感染伴胃肠道不适。结论血清生物标志物可作为预测小儿阑尾炎的鉴别指标。但在鉴别诊断急性阑尾炎时,应考虑到一些类似阑尾炎的急性腹部疾病,以免误诊,进行不必要的阑尾切除术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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