| Objective: Acute appendicitis(AA) is the most common acute abdomen in surgery. There are many subjects about AA, including the causes of AA, the changes of the body and the changes of pathology and pathophysiology, and so on. The immune system plays an important role throughout the whole process of this disease. So it's very important to study the changes of the immune system. AA is a non-specifically infectious disease, the development of AA is very fast, and operations are needed in most patients with AA. So it's very necessary to diagnose accurately. The final diagnosis rate is lower than 80% according to traditional standards: 1. The WBC counts' increases(>10.0X109/L), 2.The tenderness of right lower quadrant. The serum IAP was determined in this study in order to diagnose AA accurately and evaluate prognosis correctly. IAP is an immune target that can reflect the body's immune condition. Now the research of IAP is concentrated on the patients with tumors. IAP can be used as auxiliary target to diagnose tumors, and it also can be used to monitor the recurring of tumors and evaluate the prognosis. LAP also can be used as a target to observe the effects oftreatment to tumors. IAP is not a special tumor marker(TM), so it may increase when the body is in the immunosuppressive condition. In order to know about the immune condition of patients with AA, improve the accuracy of diagnosis, and evaluate the patients' prognosis correctly, the serum immunosuppressive acidic protein (IAP) level, neutrophil:lymphocyte ratio(n:l ratio), and serum C-reactive protein (CRP) were determined.Methods: There were 151 patients with AA(including 92 males and 59 females, mean age was 30.6)in this study, and 50 other patients in normal control group(including 27 males and 23 females, mean age was 40.1). The serum IAP, CRP and IgQIgM were determined before operation, on the second and fifth days in the patients with AA. At the same time the WBC count and n:l ratio were also determined. Other clinical data were recorded as following: 1. The type of AA, 2. The duration of symptoms, 3. The temperature of patients, 4. The conditions during the operations, 5. The postoperative time that the temperature decreased to normal level. The patients with AA were divided into 3 groups: the acute simple appendicitis, the acute suppurative appendicitis, and the acute gangrenous or perforated appendicitis. And the patients were divided into 2 groups according to the WBC count: the group with high WBC count (>10.0X 109/L), and the group with normal WBC count(4.0X 109/L-10.0X 109/L). All data were dealt with SPSS9.0.Results : (1) The IAP levels in patients were significantly higher than those in normal control group(P<0.01).The IAP levels in patients with gangrenous or perforated appendicitis were significantly higher than those with simple or suppurative appendicitisCPO.Ol). (2) The preoperative IAP levels were significantly correlated with the duration of symptoms in patients(r=0.531). The IAP levels had no significant correlation with the time that the temperature decreased to normal level after operation (r=0.347). (3) The IAP levels of the second postoperative day were significantly higher than those of preoperative day(P<0.01). Although the IAP levels decreased on the fifth postoperative day, they were still significantly higher than the normal control group(P<0.01). The IAP levels of the 5th postoperative days had no significant difference with the preoperative levels (/*>().05). (4) The preoperative WBC counts of patients were higher that those of normal group (P<0.05). The WBC counts in patients with gangrenous or perforated appendicitis were significantly higher than those with simple appendicitis. The n:l ratios in patients were significantly higher than those of the normal control group(P<0.01). The n:l ratios in patients with gangrenous or perforated appendicitis were significantly higher than those in patients with simple or suppurative appendicitis (PO.01). The n:l ratios increased when the patients' conditions got worse. Sign...
|
PDF Full Text Request