| 摘要: |
| 目的 探讨C 反应蛋白（CRP）急性期快速上升能否可靠预测非创伤性急腹症的CT 检查阳性表现。方法 收集CRP 检测后24h内行腹盆、腔CT扫描的非创伤性急腹症患者121 例，其中男57例，女64例，平均年龄57岁。近期手术、已知恶性肿瘤、炎症性肠病除外。CT表现由2 位放射科医师阅片并一致后进行分类。结果 CRP 正常CT 检查阳性16 人，阴性15 人，随着CRP 升高，CT 检查阳性率也随着升高，灵敏度下降，特异度增高，似然比也随之增高，当CRP 在130mg/L 水平以上时，其灵敏度与特异度分别为31.4%、90.9%，阳性似然比为3.14。结论 CRP阴性的非创伤性急腹症患者，不能除外CT 检查，随着血清CRP 水平升高，CT检查阳性率及阳性似然比也随之升高。 |
| 关键词: C反应蛋白 CT 急腹症 |
| DOI： |
| 分类号: |
| 基金项目:义乌市医学重点建设学科资助 |
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| The value of serum C-reactive protein to predict abdomino-pelvic CT findings in the clinical setting of the non-traumatic acute abdomen |
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WANG Yongren,YU Xiaoli,HUANG Wei,YIANG Huiqiang,JING Fenghua,WANG Liping,PENG Zhiyi
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Chinese Medical Hospital of Yiwu
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| Abstract: |
| Objective The aim of this study was to determine if serum C-reactive protein(CRP), an acute phase reactant which exhibits a rapid rise in serum in inflammatory conditions, is a reliable predictor of abdomino-pelvic CT findings in the clinical setting of the non-traumatic acute abdomen. Methods 121 patients presenting with symptoms of acute abdominal pain without non-traumatic were included. Patients with serum CRP measured within 24h of the abdomino-pelvic CT scan were subselected and those with a history of recent surgery, malignancy, and inflammatory bowel disease were excluded (n=121). CT findings were graded in consensus by two radiologists，Statistical analysis was performed using SPSSv18. Results There were 16 numbers of positive and 15 negative CT scans in patients with low serum level of CRP(0~5 mg/L). As CRP level increased the Proportion of positive CTs increased (P＜0.001,Chi-square test for trend). The positive likelihood ratio for positive CT findings in patients with a CRP level greater than 130mg/L was 3.45 with reported specificity and sensitivity of 90.9 and 31.4%,Respectively. Conclusion A low CRP level (0~5 mg/L) does not out rule positive findings on CT in the clinical setting of the non-traumatic acute abdomen. Increasing levels of CRP predict, with increasing likelihood, positive findings on CT. |
| Key words: C-reative protein CT Acute abdomen |
