摘要
背景阑尾炎、肾绞痛是引起急性非创伤性腹痛的常见疾病,是否可以通过常用的辅助检查血液及尿液分析即可诊断肾绞痛和阑尾炎,将成为医疗条件有限的医疗机构需要关注的问题。目的探讨血液分析、尿液分析在肾绞痛及阑尾炎诊断上的意义。方法选取2019年1—12月中山大学附属第六医院确诊为阑尾炎(阑尾炎组)或肾绞痛(肾绞痛组)患者117例。收集两组患者的一般资料、血液分析结果、尿液分析结果。对两组患者血液分析指标白细胞计数(WBC)、红细胞计数(RBC)、中性粒细胞计数(NEUT)、中性粒细胞比值(NEUT%)、血白红细胞比,以及尿液分析指标尿白细胞计数(UWBC)、尿红细胞计数(URBC)、尿白红细胞比进行比较。并采用受试者工作特征(ROC)曲线分析以上指标的诊断价值。结果两组患者血液分析指标WBC、RBC、NEUT、NEUT%、血白红细胞比比较,差异均无统计学意义(P>0.05);而阑尾炎患者尿液分析指标URBC、UWBC水平低于肾绞痛患者,尿白红细胞比高于肾绞痛患者(P<0.05)。URBC诊断肾绞痛的临界值为14.52/μl,灵敏度为0.892,特异度为0.864,AUC为0.921[95%CI(0.877,0.964),P<0.01];UWBC诊断肾绞痛的临界值为16.5/μl,灵敏度为0.486,特异度为0.864,AUC为0.705[95%CI(0.628,0.782),P<0.01],尿白红细胞比诊断阑尾炎的临界值为0.922,灵敏度为0.838,特异度为0.606,AUC为0.742[95%CI(0.662,0.822),P<0.01]。结论 URBC、UWBC对肾绞痛有较好诊断价值,尿白红细胞比对阑尾炎有诊断价值。
Background Appendicitis and renal colic are two common causes of acute non-traumatic abdominal pain.Whether they can be diagnosed by common laboratory blood and urine analyses has become a focus of medical institutions with limited medical resources.Objective To explore the predictive value of blood and urine analyses for renal colic and appendicitis.Methods From January to December 2019,117 patients with a definite diagnosis of appendicitis or renal colic were recruited from The Sixth Affiliated Hospital of Sun Yat-sen University.General clinical data,results of laboratory blood and urine analyses were collected.Laboratory blood indicators[white blood cell(WBC) count,red blood cell(RBC) count,neutrophil(NEUT) count,neutrophil percentage(NEUT%),ratio of WBCs to RBCs],and urine indicators[WBC count,RBC count and ratio of WBC count to RBC count in urine] were compared between appendicitis and renal colic patients,and the predictive value of indicators with significant intergroup differences for renal colic and appendicitis was estimated using the receiver operating characteristic(ROC) curve analysis.Results Appendicitis and renal colic patients demonstrated no significant differences in mean WBC count,RBC count and NEUT count,NEUT% and ratio of WBC count to RBC count(P>0.05).But appendicitis patients had lower mean RBC count and WBC count in urine,and higher ratio of WBC count to RBC count in urine(P<0.05).So the ROC curve for estimating the predictive value of RBC count,WBC count,and ratio of WBC count to RBC count in urine for renal colic was plotted and the analysis revealed that the AUC of RBC count in urine was 0.921[95%CI(0.877,0.964),P<0.01],with 0.892 sensitivity,0.864 specificity when the optimal cut-off value was chosen as 14.52/μl;the AUC of WBC count in urine was 0.705[95%CI(0.628,0.782),P<0.01],with 0.486 sensitivity,0.864 specificity when the optimal cut-off value was chosen as 16.5/μl.The ROC curve for estimating the predictive value of RBC count,WBC count and ratio of WBC count to RBC count in uri
作者
陈小兵
吴桂昌
CHEN Xiaobing;WU Guichang(The Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,China)
出处
《中国全科医学》
CAS
北大核心
2021年第17期2198-2201,2206,共5页
Chinese General Practice
关键词
急腹症
肾绞痛
阑尾炎
血液化学分析
尿分析
诊断
鉴别
灵敏度
特异度
Abdomen
acute
Renal colic
Appendicitis
Blood chemical analysis
Urinalysis
Diagnosis
differential
Sensitivity
Specificity
