中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2010年
2期
142-144,147
,共4页
胰腺炎%全身炎症反应综合征%Balthazar-CTSI评分
胰腺炎%全身炎癥反應綜閤徵%Balthazar-CTSI評分
이선염%전신염증반응종합정%Balthazar-CTSI평분
Pancreatitis%Systemic inflammatory response syndrome%Balthazar-CTSI score
目的 探讨急性胰腺炎(AP)并发全身炎症反应综合征(SIRS)的临床价值以及SIRS与AP预后、Balthazar-CTSI评分之间的关系,并进一步研究SIRS阳性、SIRS持续阳性及SIRS严重程度在预测胰腺病变程度、胰周并发症发生及AP预后中的意义.方法 分别记录278例AP患者入院后第1～7天的SIRS评分、7 d内SIRS阳性持续天数、7 d内SIRS最高评分以及患者入院3 d后的Balthazar-CTSI评分,并分别按Balthazar-CTSI评分≤3分、4～6分及>6分划分等级,并行相关统计学分析.结果 (1)SIRS组和无SIRS组患者病死率(分别为10.34%和0.75%)间差异有统计学意义(P<0.01).(2)入院后SIRS阳性及SIRS持续2 d、3 d、5 d、7 d阳性均与Balthazar-CTSI评分等级呈正相关(rs分别为0.5502、0.6251、0.7267、0.7898、0.6733,P均<0.01).(3)按入院SIRS持续天数将AP合并SIRS患者分为持续1 d、2 d、3 d、5 d、7 d组,分别作为A、B、C、D、E组.A组、B组患者Balthazar-CTSI评分>3分者所占比例(53.79%和60.47%)分别与C组、D组、E组(85.00%、90.28%和95.83%)比较,差异均有统计学意义(P<0.05).(4)按SIRS评分进行分组,SIRS评分0～1分为Ⅰ组,2分为Ⅱ组,3分为Ⅲ组,4分为Ⅳ组,4组患者Balthazar-CTSI评分>3分者分别为2例(1.53%)、1例(3.57%)、18例(38.30%)和61例(84.72%).Ⅰ组、Ⅱ组患者Balthazar-CTSI评分>3分者所占比例分别与Ⅲ组、Ⅳ组比较,Ⅲ组与Ⅳ组比较,差异均有统计学意义(P<0.05).结论 AP患者SIRS的发生与疾病的转归有关;SIRS持续阳性≥3 d及SIRS评分>2分可以提高对胰腺病变严重程度以及胰周并发症发生的预测能力.
目的 探討急性胰腺炎(AP)併髮全身炎癥反應綜閤徵(SIRS)的臨床價值以及SIRS與AP預後、Balthazar-CTSI評分之間的關繫,併進一步研究SIRS暘性、SIRS持續暘性及SIRS嚴重程度在預測胰腺病變程度、胰週併髮癥髮生及AP預後中的意義.方法 分彆記錄278例AP患者入院後第1～7天的SIRS評分、7 d內SIRS暘性持續天數、7 d內SIRS最高評分以及患者入院3 d後的Balthazar-CTSI評分,併分彆按Balthazar-CTSI評分≤3分、4～6分及>6分劃分等級,併行相關統計學分析.結果 (1)SIRS組和無SIRS組患者病死率(分彆為10.34%和0.75%)間差異有統計學意義(P<0.01).(2)入院後SIRS暘性及SIRS持續2 d、3 d、5 d、7 d暘性均與Balthazar-CTSI評分等級呈正相關(rs分彆為0.5502、0.6251、0.7267、0.7898、0.6733,P均<0.01).(3)按入院SIRS持續天數將AP閤併SIRS患者分為持續1 d、2 d、3 d、5 d、7 d組,分彆作為A、B、C、D、E組.A組、B組患者Balthazar-CTSI評分>3分者所佔比例(53.79%和60.47%)分彆與C組、D組、E組(85.00%、90.28%和95.83%)比較,差異均有統計學意義(P<0.05).(4)按SIRS評分進行分組,SIRS評分0～1分為Ⅰ組,2分為Ⅱ組,3分為Ⅲ組,4分為Ⅳ組,4組患者Balthazar-CTSI評分>3分者分彆為2例(1.53%)、1例(3.57%)、18例(38.30%)和61例(84.72%).Ⅰ組、Ⅱ組患者Balthazar-CTSI評分>3分者所佔比例分彆與Ⅲ組、Ⅳ組比較,Ⅲ組與Ⅳ組比較,差異均有統計學意義(P<0.05).結論 AP患者SIRS的髮生與疾病的轉歸有關;SIRS持續暘性≥3 d及SIRS評分>2分可以提高對胰腺病變嚴重程度以及胰週併髮癥髮生的預測能力.
목적 탐토급성이선염(AP)병발전신염증반응종합정(SIRS)적림상개치이급SIRS여AP예후、Balthazar-CTSI평분지간적관계,병진일보연구SIRS양성、SIRS지속양성급SIRS엄중정도재예측이선병변정도、이주병발증발생급AP예후중적의의.방법 분별기록278례AP환자입원후제1～7천적SIRS평분、7 d내SIRS양성지속천수、7 d내SIRS최고평분이급환자입원3 d후적Balthazar-CTSI평분,병분별안Balthazar-CTSI평분≤3분、4～6분급>6분화분등급,병행상관통계학분석.결과 (1)SIRS조화무SIRS조환자병사솔(분별위10.34%화0.75%)간차이유통계학의의(P<0.01).(2)입원후SIRS양성급SIRS지속2 d、3 d、5 d、7 d양성균여Balthazar-CTSI평분등급정정상관(rs분별위0.5502、0.6251、0.7267、0.7898、0.6733,P균<0.01).(3)안입원SIRS지속천수장AP합병SIRS환자분위지속1 d、2 d、3 d、5 d、7 d조,분별작위A、B、C、D、E조.A조、B조환자Balthazar-CTSI평분>3분자소점비례(53.79%화60.47%)분별여C조、D조、E조(85.00%、90.28%화95.83%)비교,차이균유통계학의의(P<0.05).(4)안SIRS평분진행분조,SIRS평분0～1분위Ⅰ조,2분위Ⅱ조,3분위Ⅲ조,4분위Ⅳ조,4조환자Balthazar-CTSI평분>3분자분별위2례(1.53%)、1례(3.57%)、18례(38.30%)화61례(84.72%).Ⅰ조、Ⅱ조환자Balthazar-CTSI평분>3분자소점비례분별여Ⅲ조、Ⅳ조비교,Ⅲ조여Ⅳ조비교,차이균유통계학의의(P<0.05).결론 AP환자SIRS적발생여질병적전귀유관;SIRS지속양성≥3 d급SIRS평분>2분가이제고대이선병변엄중정도이급이주병발증발생적예측능력.
Objective To explore the clinical value of acute pancreatitis(AP)complicated by systemic inflammatory response syndrome(SIRS),its correlation with the prognosis of AP and Balthazar-CTSI scores,and the significance of SIRS positive,sustained SIRS positive and severity of SIRS in predicting the severity of pancreatitis,peripancreatic complications and the prognosis of AP.Methods SIRS scores on days 1～7 after admission,days of SIRS continuity,the highest SIRS score within 7 d and Balthazar-CTSI scores 3 d after admission were recorded in 278 AP patients,who were graded according to Balthazar-CTSI scores (≤3,＜3～6,＞6),and a statistical analysis was carried out.Results There was significant difference in mortality between groups SIRS and non-SIRS (10.34%,0.75%,respectively,P＜0.01 ).SIRS positive and continuous 2-,3-,5-,7-day positive after admission were positively correlated with Balthazar-CTSI scores (rs=0.5502,0.6251,0.7267,0.7898,0.6733,respectively,P＜0.01 ).AP patients with SIRS were divided according to days of SIRS continuity into groups A(1 d),B(2 d),C(3 d),D(5 d),E(7 d).The percentage of patients with ＞3 Balthazar-CTSI scores in groups A,B(53.79%,60.47%,respectively)was significantly different from that in groups C,D,E (85.00%,90.28%,95.83%,respectively)(P＜0.05).The patients were divided according to SIRS scores into groups Ⅰ(0～1),Ⅱ(2),Ⅲ(3),Ⅳ (4),in whom the number of patients with ＞3 Balthazar-CTSI scores was 2(1.53%),1(3.57%),18(38.30%),61(84.72%),respectively.There was significant difference in percentage of patients with ＞3 Balthazar-CTSI scores between groups Ⅰ,Ⅱ and groups Ⅲ,Ⅳ,and between groups Ⅲ and Ⅳ(P＜0.05).Conclusion SIRS occurrence is correlated with AP turnover.The ability of predicting severity of pancreatic lesions and peripancreatic complications can be improved when SIRS continuous positive score is ≥3 d and SIRS ＞2.
