Abstract: Objective To investigate the diagnostic value of neutrophil lymphocyte ratio(NLR),white blood cell count(WBC) and C-reactive protein(CRP) in children with complex appendicitis.Methods Children with acute appendicitis who were treated in our Hospital from January 2020 to December 2021 were divided into complex appendicitis group(120 cases in  used as the observation group) and simple appendicitis group(100 cases as the control group).The differences of gender,age,NLR,WBC and CRP between the two groups were compared.The influencing indexes of complex appendicitis were screened by univariate analysis,and the independent risk factors of complex appendicitis were screened by regression analysis.The receiver operating characteristic curve(ROC) was used to predict the diagnostic value of NLR,WBC and CRP indexes in children with complex appendicitis. Results Univariate analysis showed that NLR,WBC and CRP were the influencing factors of complex appendicitis;Multivariate analysis showed that NLR,WBC and CRP were independent risk factors for complex appendicitis.ROC analysis showed that the area under the curve(AUC) of NLR,WBC and CRP were 0.843 [95% CI:(0.791,0.894)],0.766 [95% CI:(0.704,0.827)],0.699 [95% CI:(0.631,0.767)];The AUC of NLR combined WBC,NLR combined CRP,NLR combined WBC and CRP were 0.869 [95% CI:(0.823,0.915)],0.888 [95% CI:(0.846,0.930)],0.902 [95% CI:(0.863,0.941)].Conclusion NLR,WBC and CRP have good predictive value in the diagnosis of complex appendicitis in children,and have important clinical reference significance.

Key words: acute appendicitis, Neutrophil lymphocyte ratio, white blood cell count, C-reactive protein