The study on the diagnostic value of neutrophil-to-lymphocyte ratio combined with fibrinogen in children with complex appendicitis
10.3760/cma.j.issn.1673-4912.2025.11.007
- VernacularTitle:中性粒细胞与淋巴细胞比值联合纤维蛋白原对儿童复杂性阑尾炎的诊断价值研究
- Author:
Baodong DING
1
;
Xiaofei JI
;
Jie XU
Author Information
1. 山东第二医科大学附属益都中心医院儿科，青州 262500
- Publication Type:Journal Article
- Keywords:
Complex appendicitis;
Children;
Neutrophil-to-lymphocyte ratio;
Fibrinogen
- From:
Chinese Pediatric Emergency Medicine
2025;32(11):837-841
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the diagnostic value of neutrophil-to-lymphocyte ratio (NLR) combined with fibrinogen (FIB) in pediatric complex appendicitis (CA).Methods:A retrospective analysis was conducted on clinical data of children diagnosed with acute appendicitis who were admitted to the Department of Pediatric Surgery, Affiliated Yidu Central Hospital of Shandong Second Medical University from December 2022 to June 2024. Patients were divided into CA group and simple appendicitis (SA) group based on postoperative pathological types. Clinical characteristics (age, weight, fever), and laboratory indices (NLR, FIB) were compared between the two groups. Multivariate Logistic regression was used to identify risk factors for CA. Receiver operating characteristic (ROC) curves were plotted to evaluate predictive values.Results:A total of 141 children were enrolled: 74 in SA group[41 males, 33 females; mean age (10.25±2.54) years] and 67 in CA group[37 males, 30 females; mean age (8.40±2.96) years]. No significant gender difference was observed ( P>0.05). CA group had younger age, lower median weight, and higher fever rate than SA group ( P<0.05). Laboratory findings showed CA group had higher leukocyte count, neutrophil count, monocyte count, NLR, and FIB levels, but lower lymphocyte count compared to SA group ( P<0.05). Multivariate Logistic regression identified NLR and FIB as independent risk factors for CA, while weight was a protective factor. ROC analysis revealed AUCs of 0.807 (95% CI 0.736-0.879, P<0.001) for NLR, 0.788 (95% CI 0.712-0.863) for FIB, and 0.830 (95% CI 0.763-0.897) for combined detection, with 71.6% sensitivity and 81.1% specificity. Conclusion:NLR and FIB show predictive value for pediatric CA, with enhanced efficacy when combined. Thus, NLR combined with FIB can serve as a reference indicator for surgical decision-making in children with acute appendicitis.
