目的 比较超声和改良Alvarado评分对老年人急性阑尾炎的诊断价值。方法 回顾性分析200例有明确手术结果的主诉为急性右下腹痛的、年龄≥60岁的患者，采用受试者工作特征(ROC)曲线比较超声和改良Alvarado评分的诊断性能。结果 超声检查的灵敏度、特异度、阳性预测值和阴性预测值分别为85.31%、82.46%、92.42%和69.12%，ROC曲线下面积(AUC)为0.890。改良Alvarado评分的AUC略低，为0.782，截断值为6时，其灵敏度、特异度、阳性预测值和阴性预测值分别为87.41%、73.68%、89.29%和70.0%。结论 超声检查和改良Alvarado评分对老年人急性阑尾炎的诊断价值相当，两者结合对早期诊断和治疗有一定参考价值。

Objective To compare the diagnostic value of the ultrasonography and modified Alvarado score for elderly patients with acute appendicitis. Methods A retrospective analysis of 200 patients with complaints of acute right lower abdominal pain, clear surgical results, and age over 60 years was conducted. The diagnostic value of the ultrasonography and modified Alvarado score was compared by the receiver operating characteristic (ROC) curves. Results The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the ultrasonography were 85.31%, 82.46%, 92.42% and 69.12%, respectively. The area under the ROC curve (AUC) was 0.890. AUC of the modified Alvarado score was 0.782, slightly lower than that of the ultrasonography. The sensitivity, specificity, PPV, and NPV were 87.41%, 73.68%, 89.29% and 70.0%, respectively for the cut-off point of 6. Conclusion The diagnostic value of the ultrasonography is equivalent to that of the modified Alvarado score for elderly patients with acute appendicitis. Combination of them has certain reference value for early diagnosis and treatment.