PDF(Pubmed)
Abstract：
BACKGROUND: Acute appendicitis is a common abdominal emergency observed in emergency departments (ED). Distinguishing between uncomplicated and complicated appendicitis is important in determining a treatment strategy. Serum soluble vascular cell adhesion molecule-1 (VCAM-1) is an inflammatory biomarker. We aimed to determine the role of VCAM-1 in predicting complicated appendicitis in children.
METHODS: Pediatric patients with suspected appendicitis admitted to the ED were enrolled in this prospective study. Pre-surgical serum VCAM-1 was tested in children with acute appendicitis within 72 h of symptoms (from day 1 to day 3). Serum VCAM-1 levels were further analyzed and compared between patients with and without complicated appendicitis.
RESULTS: Among the 226 pediatric appendicitis patients, 70 had uncomplicated appendicitis, 138 had complicated appendicitis, and 18 had normal appendices. The mean serum VCAM-1 levels in patients with perforated appendicitis were higher than in those with simple appendicitis (p < 0.001). On day 1 to day 3, the mean VCAM-1 levels in patients with complicated appendicitis were all significantly higher than in those with uncomplicated appendicitis (all p < 0.001).
CONCLUSIONS: Serum VCAM-1 levels may be helpful in differentiating uncomplicated and complicated appendicitis in children and could predict appendiceal perforation.
METHODS: Pediatric patients with suspected appendicitis admitted to the ED were enrolled in this prospective study. Pre-surgical serum VCAM-1 was tested in children with acute appendicitis within 72 h of symptoms (from day 1 to day 3). Serum VCAM-1 levels were further analyzed and compared between patients with and without complicated appendicitis.
RESULTS: Among the 226 pediatric appendicitis patients, 70 had uncomplicated appendicitis, 138 had complicated appendicitis, and 18 had normal appendices. The mean serum VCAM-1 levels in patients with perforated appendicitis were higher than in those with simple appendicitis (p < 0.001). On day 1 to day 3, the mean VCAM-1 levels in patients with complicated appendicitis were all significantly higher than in those with uncomplicated appendicitis (all p < 0.001).
CONCLUSIONS: Serum VCAM-1 levels may be helpful in differentiating uncomplicated and complicated appendicitis in children and could predict appendiceal perforation.
摘要：
背景：急性阑尾炎是急诊（ED）中常见的腹部急症。区分不复杂和复杂的阑尾炎对于确定治疗策略很重要。血清可溶性血管细胞粘附分子-1(VCAM-1)是一种炎性生物标志物。我们旨在确定VCAM-1在预测儿童复杂性阑尾炎中的作用。
方法：在这项前瞻性研究中纳入疑似阑尾炎的儿科患者。在出现症状72小时内（从第1天到第3天）对急性阑尾炎患儿进行手术前血清VCAM-1测试。进一步分析并比较有无复杂性阑尾炎患者的血清VCAM-1水平。
结果：在226名小儿阑尾炎患者中，70人患有简单的阑尾炎,138人患有复杂的阑尾炎,18例阑尾正常。穿孔性阑尾炎患者的平均血清VCAM-1水平高于单纯性阑尾炎患者（p<0.001）。在第1天至第3天，复杂性阑尾炎患者的平均VCAM-1水平均显着高于非复杂性阑尾炎患者（均p<0.001）。
结论：血清VCAM-1水平可能有助于区分儿童单纯性和复杂性阑尾炎，并可预测阑尾穿孔。
方法：在这项前瞻性研究中纳入疑似阑尾炎的儿科患者。在出现症状72小时内（从第1天到第3天）对急性阑尾炎患儿进行手术前血清VCAM-1测试。进一步分析并比较有无复杂性阑尾炎患者的血清VCAM-1水平。
结果：在226名小儿阑尾炎患者中，70人患有简单的阑尾炎,138人患有复杂的阑尾炎,18例阑尾正常。穿孔性阑尾炎患者的平均血清VCAM-1水平高于单纯性阑尾炎患者（p<0.001）。在第1天至第3天，复杂性阑尾炎患者的平均VCAM-1水平均显着高于非复杂性阑尾炎患者（均p<0.001）。
结论：血清VCAM-1水平可能有助于区分儿童单纯性和复杂性阑尾炎，并可预测阑尾穿孔。
