RIPAS阑尾炎评分对可疑急性阑尾炎的诊断价值

摘要

目的：研究RIPAS阑尾炎（RIPASA）评分对可疑急性阑尾炎的诊断价值。方法：对2014年1月－2015年1月诊断的可疑急性阑尾炎患者150例分别以 Alvarado 评分和 RIPASA 评分进行评估，比较其诊断价值。结果：以7．5分和7分定义为 RIPASA 和 Alvarado 评分的最佳界值，RIPASA 评分和 Alvarado 评分诊断急性阑尾炎的敏感度、特异度、阳性预测值、阴性预测值、准确率、阑尾阴性切除率分别为（97．50％、81．42％、85．71％、96．61％、90．30％、14．29％）和（68．75％、87．14％、85．93％、70．93％、73．80％、14．06％）；使用 RIPASA 和 Alvarado 评分对可疑急性阑尾炎患者评估结果与综合临床诊断结果相关联，且 RIPASA 评分关联程度明显高于 Alvarado 评分（P＜0．05）。结论：急诊医师使用RIPASA评分对中国大陆地区东方人种可疑急性阑尾炎患者进行辅助诊断优于Alvarado 评分。%Objective: To study the diagnosis value of the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score for patients with suspected acute appendicitis. Methods: 150 patients with suspected acute appendicitis were evaluated with the RIPASA score and Alvarado scores respectively to compare the diagnosis value. erived, but decisions for appendicectomy were based on clinical judgement. Receiver operating curve (ROC), sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) for both scoring systems were calculated. Results: At the optimal cut-off threshold score of 7.5 derived from the ROC,the RIPASA score showed a diagnostic Se 97.50%,Sp 81.42%,PPV 85.71%,NPV 96.61% and diagnostic accuracy 90.30%,respectively. At the cut-off threshold score of 7.0,the Alvarado score showed a diagnostic Se 68.75%,Sp 87.14%,PPV 85.93%,NPV 70.93% and diagnostic accuracy 73.80%,respectively. Predicted negative appendicectomy rates for RIPASA and Alvarado score were 14.29% and 14.06%,respectively (P > 0.05). Conclusion: The RIPASA score is a better diagnostic scoring system than the Alvarado score for the diagnosis of suspected acute appendicitis in China.