Urokinase-type plasminogen activator receptor combined with modified Alvarado scoring system and C-reactive protein for diagnosis of acute appendicitis in children

Chuanwei SUN; Aijun LI; Hong SUN; Wei ZHANG; Guibo WANG; Jie LEI; Zhonggang YANG

doi:10.16016/j.1000-5404.202005235

您当前的位置：

首页 >

文章列表页 >

Urokinase-type plasminogen activator receptor combined with modified Alvarado scoring system and C-reactive protein for diagnosis of acute appendicitis in children

Pediatric Clinical reseach | 更新时间：2026-01-09

- Urokinase-type plasminogen activator receptor combined with modified Alvarado scoring system and C-reactive protein for diagnosis of acute appendicitis in children
- Journal of Third Military Medical University Vol. 42, Issue 22, Pages: 2176-2181(2020)
- 作者机构：
  
  075000 河北张家口, 河北北方学院附属第一医院儿外科
- 作者简介：
- 基金信息：
  
  the Tackling Project of Science and Technology Research Plan of Zhangjiakou(1421144D)
- DOI：10.16016/j.1000-5404.202005235
  CLC： R446.11;R726.568
- Received：26 May 2020，
  
  Revised：2020-09-15，
  
  Published：30 November 2020
- 稿件说明：
移动端阅览
Chuanwei SUN, Aijun LI, Hong SUN, et al. Urokinase-type plasminogen activator receptor combined with modified Alvarado scoring system and C-reactive protein for diagnosis of acute appendicitis in children[J]. Journal of Third Military Medical University, 2020, 42(22): 2176-2181.
DOI：

Chuanwei SUN, Aijun LI, Hong SUN, et al. Urokinase-type plasminogen activator receptor combined with modified Alvarado scoring system and C-reactive protein for diagnosis of acute appendicitis in children[J]. Journal of Third Military Medical University, 2020, 42(22): 2176-2181. DOI： 10.16016/j.1000-5404.202005235.

摘要

目的

探讨急性阑尾炎患儿血清中尿激酶型纤溶酶原激活物受体(urokinase-type plasminogen activator receptor

uPAR)的水平，并评价其联合C反应蛋白(C-reactive protein

CRP)、改良Alvarado评分的诊断价值。

方法

对我院2017年6月至2019年6月期间57例经病理诊断的急性阑尾炎患儿和44例非阑尾炎腹痛患儿进行研究。分析两组患儿年龄、性别、白细胞(white blood cell

WBC)、中性粒细胞与淋巴细胞比率(neutrophil to lymphocyte ratio

NLR)、CRP水平、中性粒细胞百分数、改良Alvarado评分及uPAR水平差异。评估血清uPAR与CRP、改良Alvarado评分的相关性并采用ROC曲线探索上述指标单独或联合对急性阑尾炎的诊断效能。根据净重新分类指数(net reclassification index，NRI)和整体鉴别指数(integrated discrimination index，IDI)评价各联合模型对疾病的诊断价值。

结果

在急性阑尾炎患儿中，WBC、NLR、改良Alvarado评分、CRP及uPAR水平高于对照组患儿。uPAR水平与改良Alvarado评分、CRP具有良好正相关关系。CRP+改良Alvarado评分、uPAR+CRP+改良Alvarado评分的ROC曲线下面积(area under curve

AUC)分别为0.819(0.730~0.888)、0.823(0.734~0.891)，其对应的NRI、IDI分别增加0.653(0.316~0.990)、0.086(0.036~0.136)。

结论

uPAR与改良Alvarado评分、CRP联合检测可作为儿童急性阑尾炎的一个有效诊断指标。

Abstract

Objective

To investigate the serum level of urokinase-type plasminogen activator receptor (uPAR) in children with acute appendicitis and assess the diagnostic value of uPAR combined with C-reactive protein (CRP) and modified Alvarado score for acute appendicitis.

Methods

We analyzed the clinical data of 57 children with pathologically confirmed acute appendicitis and 44 children with nonappendicitis abdominal pain (control group) admitted in our hospital between June 2017 and June 2019. We compared the age

gender

white blood cell count

neutrophil/lymphocyte ratio (NLR)

CRP level

percentage of neutrophils

modified Alvarado score and serum uPAR level between the 2 groups. The correlation of serum uPAR level with CRP and modified Alvarado score was evaluated

and receiving-operator characteristic (ROC) curve was used to analyze their diagnostic efficacy

either alone or in combination

for acute appendicitis. The diagnostic value of each combined model was evaluated according to net reclassification improvement (NRI) and integrated discrimination index (IDI).

Results

White blood cell count

NLR

modified Alvarado score

CRP and uPAR levels were significantly higher in children with acute appendicitis than those in the control group. Serum uPAR level showed significantly positive correlations with modified Alvarado score and CRP level. The areas under the ROC curve of CRP combined with modified Alvarado score and uPAR combined with both CRP and modified Alvarado score were 0.819 (0.730~0.888) and 0.823 (0.734~0.891)

respectively; the NRI and IDI of uPAR combined with CRP and modified Alvarado score was 0.653 (0.316~0.990) and 0.086 (0.036~0.136)

respectively.

Conclusion

Serum uPAR level combined with modified Alvarado score and CRP can be used as an effective diagnostic indicator for acute appendicitis in children.

关键词

Keywords

references

顾秀婷, 王苇, 尹笑笑, 等.小儿急性阑尾炎多层螺旋CT分级与病理表现比较研究[J].临床放射学杂志, 2018, 37(1): 118-121.

GU X T, WANG W, YIN X X, et al . Pediatric acute appendicitis: multi-slice spiral CT grade and pathological findings[J ] . J Clin Radiol, 2018, 37(1): 118-121.

SARSU S B, ERBAGCI A B, ULUSAL H, et al . The place of calprotectin, lactoferrin, and high-mobility group box 1 protein on diagnosis of acute appendicitis with children[J ] . Indian J Surg, 2017, 79(2): 131-136. DOI: 10.1007/s12262-015-1441-2.

SWENSON D W, AYYALA R S, SAMS C, et al . Practical imaging strategies for acute appendicitis in children[J ] . Am J Roentgenol, 2018, 211(4): 901-909. DOI: 10.2214/ajr.18.19778.

DZIB-CALAN E A, HERNÁNDEZ-ROJAS M A, MURATA C, et al . Modification of Alvarado score with pain semiology for the diagnosis of acute appendicitis[J ] . Cir Cir, 2019, 87(6): 674-681. DOI: 10.24875/ciru.19000866.

RASTOVIC P, TRNINIC Z, GALIC G, et al . Accuracy of modified alvarado score, eskelinen score and ohmann score in diagnosing acute appendicitis[J ] . Psychiatr Danub, 2017, 29(suppl2): 134-141.

ORLOVA E, YEH A, SHI M, et al . Genetic association and differential expression of PITX2 with acute appendicitis[J ] . Hum Genet, 2019, 138(1): 37-47. DOI: 10.1007/s00439-018-1956-2.

STRINGER M D. Acute appendicitis[J]. J Paediatr Child Health, 2017, 53(11): 1071-1076. DOI: 10.1111/jpc.13737.

REISMANN J, ROMUALDI A, KISS N, et al . Diagnosis and classification of pediatric acute appendicitis by artificial intelligence methods: an investigator-independent approach[J ] . PLoS ONE, 2019, 14(9): e0222030. DOI: 10.1371/jou rnal.pone.0222030.

KEASEY M P, JIA C H, PIMENTEL L F, et al . Bloodvitronectin is a major activator of LIF and IL-6 in the brain through integrin -FAK and uPAR signaling[J ] . J Cell Sci, 2018, 131(3): 1-13.DOI: 10.1242/jcs.202580.

RUBINA K A, SYSOEVA V Y, ZAGORUJKO E I, et al . Increased expression of uPA, uPAR, and PAI-1 in psoriatic skin and in basal cell carcinomas[J ] . Arch Dermatol Res, 2017, 309(6): 433-442. DOI: 10.1007/s00403-017-1738-z.

ALI A, MUCAGIT G, ÖMER V Ö, et al .The diagnostic value of serum urokinase-type plasminogen activator receptor in acute appendicitis[J ] . Ulus Travma Acil Cerrahi Derg, 2019, 25(5): 467-473. DOI: 10.5505/tjtes.2019.55623

SNYDER M J, GUTHRIE M, CAGLE S. Acute appendi-citis: efficient diagnosis and management[J]. Am Fam Phy-sician, 2018,98(1): 25-33.

HORI T, MACHIMOTO T, KADOKAWA Y, et al . Laparoscopic appendectomy for acute appendicitis: How to discou-rage surgeons using inadequate therapy[J ] . World J Gastroenterol, 2017, 23(32): 5849-5859. DOI: 10.3748/wjg.v23.i32.5849.

SALMINEN P, TUOMINEN R, PAAJANEN H, et al . Five-year follow-up of antibiotic therapy for uncomplicated acute appendicitis in the APPAC randomized clinicaltrial[J ] . JAMA, 2018, 320(12): 1259-1265. DOI: 10.1001/jama.2018.13201.

雷斌, 戚雯琰.降钙素原在小儿急性阑尾炎诊治中的临床应用[J].实用医学杂志, 2014, 30(12): 1984-1986. DOI: 10.3969/j.issn.1006-5725.2014.12.043

LEI B, QI W Y. Clinical application of procalcitonin in the diagnosis and treatment of acute appendicitis in children[J]. J Pract Med, 2014, 30(12): 1984-1986. DOI: 10.3969/j.issn.1006-5725.2014.12.043

DELGADO-MIGUEL C, MUNOZ-SERRANO A J, BARRENA DELFA S, et al . Neutrophil-to-lymphocyte ratio as a predictor of peritonitis in acute appendicitis in children[J ] . Cir Pediatr, 2019, 32(4): 185-189.

艾龙龙, 张玉江, 张童鑫, 等. RIPASA评分和血清总胆红素及C反应蛋白在急性阑尾炎中的诊断价值研究[J].中国全科医学, 2018, 21(32): 58-63.

AI L L, ZHANG Y J, ZHANG T X, et al . RIPASA score, serum total bilirubin and c-reactive protein for the diagnosis of acute appendicitis[J ] . Chin Gen Prac, 2018, 21(32): 58-63. DOI: 10.12114/j.issn.1007-9572.2018.00.021

WITHERS A S, GRIEVE A, LOVELAND J A. Correlation of white cell count and CRP in acute appendicitis in paediatric patients[J]. S Afr J Surg, 2019, 57(4): 40.

MATUSZCZAK E, TYLICKA M, DEBEK W, et al . Concentration of proteasome in the blood plasma of children with acute appendicitis, before and after surgery, and its correlation with CRP[J ] . World J Surg, 2018, 42(7): 2259-2264. DOI: 10.1007/s00268-017-4407-7.

GUO H, ZHOU L X, MA H Z, et al . Soluble urokinase-type plasminogen activator receptor and urokinase-type plasminogen activator receptor contribute to chemoresistance in leukemia[J ] . Oncol Lett, 2017, 14(1): 383-389. DOI: 10.3892/ol.2017.6150.

NUSSHAG C, RUPP C, SCHMITT F, et al . Cell cycle biomarkers and soluble urokinase-type plasminogen activator receptor for the prediction of Sepsis-induced acute kidney injury requiring renal replacement therapy: a prospective, exploratory study[J ] . Crit Care Med, 2019, 47(12): e999-e1007. DOI: 10.1097/ccm.0000000000004042.

ICHIHARA N, MIYAMURA M, MAEDA D, et al . Association between serum soluble urokinase-type plasminogen activator receptor and atrial fibrillation[J ] . J Arrhythm, 2017, 33(5): 469-474. DOI: 10.1016/j.joa.2017.05.003.

DAL F. Role of alvarado score and biological indicators of c-reaktif protein, procalicitonin and neopterin in diagnosis of acute appendicitis[J]. Ulus Travma Acil Cerrahi Derg, 2018, 25(3): 229-237. DOI: 10.5505/tjtes.2018.57362.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

No data

Related Author

No data

Related Institution

No data

⁰