رسائل ماجيستير
English
2022
The Role of C-reactive Protein and Procalcitonin in Differentiating Complicated and Non-Complicated Acute Appendicitis in Babylon Province
رعد غازي فيصل شلتاغ, مؤيد عمران الغزالي, مهند عباس الشلاه
كلية الطب-جامعة بابل · العراق
Appendicitis is the inflammation of the vermiform appendix which is the most common cause of acute abdomen in both adults and children all over the world. Appendicitis occurs most commonly between the ages of 10 and 20 years and it has a male-to-female ratio of 1.4:1. The lifetime risk is 8.6% for males and 6.7% for females in the United States , The global incidence of appendicitis is ( 100 in North America, 105 in Eastern Europe, and 150 in Western Europe) in 100.000person per year . The incidence is 160/100.000 person per year for Turkey The aim of this study is to determine the role of C-reactive protein and procalciton in as a markers to support modified Alvarado Score in differentiating Complicated Acute Appendicitis from Non-Complicated Acute Appendicitis by estimating the sensitivity and specificity of each of them, as well as which is more powerful to add to the diagnostic protocol.To achieve this aims, 100 patients suffer from acute appendicitis with ages range between (15-55) years are classified into two groups according to the severity , 60 patients with non-complicated acute appendicitis, 40 patients with complicated acute appendicitis. C-reactive protein, procalcitonin concentration were determined by enzyme linked Immunosorbent assay (ELISA)method, Also total serum bilirubin was estimated by spectrophotometric method .
The results of present study reveals a significant increase in C-reactive proteincon centration (p< 0.001)in complicated acute appendicitis patients when compared to those of the non-complicated acute appendicitis patients,the sensitivity and specificity of c-reactive protein was 75%,68.7% respectively .Also significant increase in procalcitonin concentration(p < 0.001) in complicated acute appendicitis patients when compared to those of the non-complicated acute appendicitis patients,the sensitivity and specificity of procalcitonin was 75%,77.8% respectively. There was non-significant increase in concentration of total serum bilirubin in complicated acute appendicitis patients more than normal range .The results showed significant positive correlations between modified Alvarado score and C-reactive protein(r = 0.216, p < 0.05 ), significant positive correlation between modified Alvarado score and procalcitonin( r = 0.265, p < 0.05) and significant positive correlation between C-reactive protein and procalcitonin(r=0.546 , p<0.005) ,In conclusion, , C-reactive protein and Procalcitonin were more effective in patients with complicated acute appendicitis ,also positive correlations between C-reactive protein and Procalcitonin with Alvarado score strength the possibility of differentiating between complicated and non-complicated acute appendicitis and Procalcitonin was more powerful from C-reactive protein in supporting modified Alvarado score to differentiate complicated from non-complicated acute appendicitis according to their sensitivity and specificity