Value of combined detection of white blood cell count,C-reactive protein and procalcitonin in the evaluation of prediction and prognosis of acute appendicitis in children

HUANG Ying-chu; ZHANG Tai-qiang; LI Guan-xuan

doi:10.3969/j.issn.1005-4057.2023.06.018

Abstract：Objective To investigate the value of combined detection of white blood cell count(WBC),C-reactive protein(CRP)and procalcitonin(PCT)in the evaluation of prediction and prognosis of acute appendicitis in children.Methods A total of 72 children with acute appendicitis were divided into Simple Acute Appendicitis Group(n=37),Purulent Appendicitis Group(n=21),and Gangrenous Appendicitis Group(n=14)according to patient's condition.The levels of WBC,CRP and PCT in peripheral venous blood of children in each group were detected before operation and 3d after operation,and their values in the evaluation of prognosis of acute appendicitis in Children were analyzed.Results Compared with those before operation,the WBC,CRP and PCT levels in the three groups decreased significantly after operation,and the differences were statistically different(P＜0.01 or 0.05).Before operation,compared with those in the Simple Acute Appendicitis Group,the WBC,CRP and PCT levels in the Purulent Appendicitis Group and the Gangrenous Appendicitis Group increased(P＜0.01 or 0.05),and the WBC,CRP and PCT levels in the Gangrenous Appendicitis Group were higher than those of the Purulent Appendicitis Group(P＜0.01);After operation,compared with those in the Simple Acute Appendicitis Group,the CRP level in the Purulent Appendicitis Group and the WBC,CRP and PCT levels of the Gangrenous Appendicitis Group increased(P＜0.01 or 0.05),and the CRP and PCT levels in the Gangrenous Appendicitis Group were higher than those of the Purulent Appendicitis Group(P＜0.0 1);3 d after operation,the WBC,CRP and PCT levels of the children with complications were all higher than those of the children without complications(P＜0.01 or 0.05).ROC curves showed that the area under the ROC curve(AUC)of preoperative WBC,CRP and PCT levels for the diagnosis of non-simple acute appendicitis were 0.663,0.708,0.680,0.792,respectively,with the sensitivity of 0.657,0.543,0.657,0.743,respectively and the specificity of 0.676,0.946,0.784,0.730,respectively(P＜0.01 or 0.05);and the AUC of the WBC,CRP and PCT levels at 3 d after operation for the diagnosis of patients with and without complications were 0.712,0.720,0.725,0.889,respectively,with the sensitivity of 0.929,0.714,0.643,0.786,respectively,and the specificity of 0.483,0.690,0.741,0.897,respectively(P＜0.01 or 0.05).Conclusion The combined detection of perioperative WBC,CRP and PCT can be used to predict the conditions and evaluate the prognosis of acute appendicitis in Children,which is worthy of clinical promotion.