中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2012年
9期
593-597
,共5页
夏璐%李晓露%诸琦%徐萍%徐凯%郭传勇%赵严%曾欣%张伟%徐敏%王兴鹏%董玲%熊光苏
夏璐%李曉露%諸琦%徐萍%徐凱%郭傳勇%趙嚴%曾訢%張偉%徐敏%王興鵬%董玲%熊光囌
하로%리효로%제기%서평%서개%곽전용%조엄%증흔%장위%서민%왕흥붕%동령%웅광소
胰腺炎,急性坏死性%损伤严重度评分%体层摄影,X线计算机%回顾性研究%预后
胰腺炎,急性壞死性%損傷嚴重度評分%體層攝影,X線計算機%迴顧性研究%預後
이선염,급성배사성%손상엄중도평분%체층섭영,X선계산궤%회고성연구%예후
Pancreatitis,acute necrotizing%Injury severity score%Tomography,X-ray computed%Retrospective studies%Prognosis
目的 对比Ranson评分、Balthazar CT严重指数(CTSI)及急性胰腺炎严重程度床边指数(BISAP评分)预测急性胰腺炎(acute pancreatitis,AP)严重程度及预后的价值.方法 收集上海地区2005年至2011年间7家医院共1004例AP患者的临床资料,进行回顾性分析.采用受试者工作特性曲线分析BISAP评分、Ranson评分及CTSI预测AP病情严重程度、预后的价值.结果 1004例AP患者中,主要病因为胆源性(580例),占57.77％.SAP发生率、胰腺坏死发生率和病死率均随着BISAP评分的增加而升高.CTSI评分≥3分患者发生胰腺坏死的风险显著高于评分＜3分患者.BISAP评分≥2分患者发生SAP、胰腺坏死的风险显著高于评分＜2分的患者[OR(95％CI)分别为4.93(3.62～6.70)和2.62(1.59～4.31)].3种评分预测AP病情进展及死亡的准确性差异无统计学意义,但BISAP评分预测AP病死率的敏感度[OR(95％CI)为61.54(35.09～87.99)]优于Ranson[OR(95％ CI)为46.15(19.05～73.25)]及CTSI[OR(95％ CI)为46.15(19.05～73.25)]评分.结论 BISAP评分操作简单,结合CTSI有助于及时对AP作出诊断和分型,能在早期准确地判断转归,预测预后,较Ranson评分更具临床应用价值.
目的 對比Ranson評分、Balthazar CT嚴重指數(CTSI)及急性胰腺炎嚴重程度床邊指數(BISAP評分)預測急性胰腺炎(acute pancreatitis,AP)嚴重程度及預後的價值.方法 收集上海地區2005年至2011年間7傢醫院共1004例AP患者的臨床資料,進行迴顧性分析.採用受試者工作特性麯線分析BISAP評分、Ranson評分及CTSI預測AP病情嚴重程度、預後的價值.結果 1004例AP患者中,主要病因為膽源性(580例),佔57.77％.SAP髮生率、胰腺壞死髮生率和病死率均隨著BISAP評分的增加而升高.CTSI評分≥3分患者髮生胰腺壞死的風險顯著高于評分＜3分患者.BISAP評分≥2分患者髮生SAP、胰腺壞死的風險顯著高于評分＜2分的患者[OR(95％CI)分彆為4.93(3.62～6.70)和2.62(1.59～4.31)].3種評分預測AP病情進展及死亡的準確性差異無統計學意義,但BISAP評分預測AP病死率的敏感度[OR(95％CI)為61.54(35.09～87.99)]優于Ranson[OR(95％ CI)為46.15(19.05～73.25)]及CTSI[OR(95％ CI)為46.15(19.05～73.25)]評分.結論 BISAP評分操作簡單,結閤CTSI有助于及時對AP作齣診斷和分型,能在早期準確地判斷轉歸,預測預後,較Ranson評分更具臨床應用價值.
목적 대비Ranson평분、Balthazar CT엄중지수(CTSI)급급성이선염엄중정도상변지수(BISAP평분)예측급성이선염(acute pancreatitis,AP)엄중정도급예후적개치.방법 수집상해지구2005년지2011년간7가의원공1004례AP환자적림상자료,진행회고성분석.채용수시자공작특성곡선분석BISAP평분、Ranson평분급CTSI예측AP병정엄중정도、예후적개치.결과 1004례AP환자중,주요병인위담원성(580례),점57.77％.SAP발생솔、이선배사발생솔화병사솔균수착BISAP평분적증가이승고.CTSI평분≥3분환자발생이선배사적풍험현저고우평분＜3분환자.BISAP평분≥2분환자발생SAP、이선배사적풍험현저고우평분＜2분적환자[OR(95％CI)분별위4.93(3.62～6.70)화2.62(1.59～4.31)].3충평분예측AP병정진전급사망적준학성차이무통계학의의,단BISAP평분예측AP병사솔적민감도[OR(95％CI)위61.54(35.09～87.99)]우우Ranson[OR(95％ CI)위46.15(19.05～73.25)]급CTSI[OR(95％ CI)위46.15(19.05～73.25)]평분.결론 BISAP평분조작간단,결합CTSI유조우급시대AP작출진단화분형,능재조기준학지판단전귀,예측예후,교Ranson평분경구림상응용개치.
Objective To compare the value of bedside index for severity in acute pancreatitis (BISAP),Ranson score and Balthazar computed tomography severity index (CTSI) in predicting the severity and prognosis of acute pancreatitis (AP).Methods From 2005 to 2011 in Shanghai,the clinical data of 1004 AP cases from seven hospitals was collected and retrospectively analyzed.The value of BISAP score,Ranson score and Balthazar CTSI in predicting the severity and prognosis of AP were assessed with receiver operator characteristic (ROC) curve.Results Among 1004 patients,the main cause of AP was biliary disease (580 cases),about 57.77％.The incidence of pancreatic necrosis,mortality and SAP increased along with BISAP score.The risk of pancreatic necrosis in patients with CTSI ≥ three was significantly higher than that of ＜ three.The risk of pancreatic necrosis and SAP in patients with BISAP score ≥ two was significantly higher than that of ＜ two (OR:4.93,95％CI 3.62-6.70; OR 2.62,95％CI 1.59-4.31,respectively).There was no significant difference in the accuracy of predicting the progression and mortality of AP among these three score systems.However the sensitivity of BISAP score (OR:61.54,95％CI 35.09-87.99) in predicting the progression and mortality of AP was better than that of Ranson (OR:46.15,95 ％ CI 19.05-73.25) and CTSI (OR:46.15,95％CI 19.05-73.25).Conclusions BISAP score is easy to perform and when combined with CTSI,it helps to make the diagnosis and classification of AP in time,predict the prognosis accurately.Compared with Ranson score,BISAP score has higher clinical value.
