CAJ | 학술논문

　　目的：对急性胰腺炎三大常用评分系统诊断轻重症的敏感度、特异性进行对比分析。方法：对患者入院后情况用三大系统APACHE-Ⅱ、Rason及Imrie系统评分，并对其得分进行判别效果分析。结果：从ROC曲线及其下面积看，对急性重症胰腺炎的诊断效果APACHE-Ⅱ系统最佳，其次为Imrie系统、Ranson系统及CTSI评分次之。将三大系统评分用文献中记录的Ranson系统3分、Imrie系统3分及APACHE-Ⅱ系统的8分、CTSI的7分作为诊断轻重症的得分临界点评价，显示其敏感度分别为APACHE-Ⅱ系统>Imrie系统>CTSI>Ranson系统，而特异性CTSI>Ranson系统>Imrie系统>APACHE-Ⅱ系统。结论：任何单一系统评分对重症胰腺炎的鉴别诊断均未能全面反映真实情况，亟待对急性胰腺炎轻、重症鉴别的评分系统进行进一步优化。
　　목적：대급성이선염삼대상용평분계통진단경중증적민감도、특이성진행대비분석。방법：대환자입원후정황용삼대계통APACHE-Ⅱ、Rason급Imrie계통평분，병대기득분진행판별효과분석。결과：종ROC곡선급기하면적간，대급성중증이선염적진단효과APACHE-Ⅱ계통최가，기차위Imrie계통、Ranson계통급CTSI평분차지。장삼대계통평분용문헌중기록적Ranson계통3분、Imrie계통3분급APACHE-Ⅱ계통적8분、CTSI적7분작위진단경중증적득분림계점평개，현시기민감도분별위APACHE-Ⅱ계통>Imrie계통>CTSI>Ranson계통，이특이성CTSI>Ranson계통>Imrie계통>APACHE-Ⅱ계통。결론：임하단일계통평분대중증이선염적감별진단균미능전면반영진실정황，극대대급성이선염경、중증감별적평분계통진행진일보우화。
Objective:To compare and evaluate the sensitivity and specificity between the mild and severe acute pancreatitis with three commonly used scoring system. Method:Grade the condition of patients after admission with three systems APACHE-Ⅱ,Rason and Imrie scoring systems,and have the discriminant analysis of the scores.Result:The area under the ROC curve from its perspective,APACHE-Ⅱsystem was the best one for the diagnosis of severe acute pancreatitis,followed by Imrie system,Ranson systems and CTSI.Referring to the critical score:Ranson system 3 points,Imrie system 3 points,APACHE-Ⅱsystem eight points,and CTSI seven points,the best sensitivity was acquired with the APACHE-Ⅱsystem,followed by Imrie system,CTSI,Ranson system,and specificity was CTSI prior to Ranson system,and followed by Imrie system and APACHE-Ⅱsystem. Conclusion:Any single system scoring on differential diagnosis of severe acute pancreatitis cannot fully reflect the real situation,and the prioritization scheme of differential scoring systems to make further optimization.