Changes and diagnostic value of C-reactive protein / albumin, Toll-like receptor 4, procalcitonin, and soluble intercellular adhesion molecule 1 levels in children with complex appendicitis#br#
ZHANG Pei QI Shiqin WEI Decheng
The Second Department of General Surgery, Anhui Children’s Hospital, Anhui Province, Hefei 230000, China
Abstract:Objective To research the changes and diagnostic value of C-reactive protein/albumin (CRP/ALB), Toll-like receptor 4 (TLR-4), procalcitonin (PCT), and soluble intercellular adhesion molecule 1 (sICAM-1) levels in children with complex appendicitis. Methods A total of 86 children with acute appendicitis who underwent surgical treatment in Anhui Children’s Hospital from June 2018 to June 2021 were selected, and they were divided into simple appendicitis group (34 cases) and complex appendicitis group (52 cases) according to the pathological type. The levels of CRP/ALB, PCT, TLR-4, and sICAM-1 in two groups were compared, the indexes affecting complex appendicitis were analyzed by logistic regression, the receiver operating characteristic (ROC) curve of each index was drawn, and the area under curve (AUC), sensitivity, and specificity were calculated. Results The levels of CRP/ALB, TLR-4, PCT, and sICAM-1 in complex appendicitis group were higher than those in simple appendicitis group, and the differences were statistically significant (P < 0.05). Logistic regression analysis showed that CRP/ALB, TLR-4, PCT, and sICAM-1 were the risk factors of complex appendicitis (OR > 1, P < 0.05). The AUC of four combined test in predicting complex appendicitis was higher than that of CRP/ALB, TLR-4, PCT, and sICAM-1 alone (P < 0.05); the sensitivity and specificity of four combined test were higher than that of CRP/ALb, TLR-4, PCT, and sICAM-1 alone. Conclusion When complex appendicitis occurs, the levels of CRP/ALB, TLR-4, PCT, and sICAM-1 in children are abnormally elevated, which are risk factors affecting complex appendicitis and have certain predictive value in prediction of appendicitis. The combined detection of the four indicators has good diagnostic and pathological value for complex appendicitis.