中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2013年
3期
157-161
,共5页
李新%晁康%姚佳燕%钟碧慧%陈旻湖
李新%晁康%姚佳燕%鐘碧慧%陳旻湖
리신%조강%요가연%종벽혜%진민호
急性胰腺炎%BISAP评分%HAP评分%预后%评分系统
急性胰腺炎%BISAP評分%HAP評分%預後%評分繫統
급성이선염%BISAP평분%HAP평분%예후%평분계통
Acute pancreatitis%BISAP score%HAP score%Prognosis%Scoring systems
目的 评价急性胰腺炎床旁严重度指数(BISAP)与无害性胰腺炎评分(HAPS)评估急性胰腺炎(AP)预后的价值.方法 回顾性分析2003年1月至2010年12月中山大学附属第一医院收治的442例AP患者资料,计算BISAP和HAP评分,绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC),分析它们对AP严重度、局部并发症、器官功能不全、预后的评估价值,并与传统的Ranson评分进行比较.结果 442例AP患者中,73例(16.5％)为重症急性胰腺炎(SAP).BISAP评分预测SAP、局部并发症、器官功能不全、病死结局的AUC分别是0.90(95％ CI:0.86～ 0.93)、0.82(95％ CI:0.76～0.89)、0.93(95％ CI:0.89 ～0.96)、0.93(95％ CI:0.87 ～0.98).BISAP评分和Ranson评分上述4项指标的AUC差异无统计学意义.HAP评分预测轻症急性胰腺炎(MAP)的特异性为85％,阳性预测值95％,AUC为0.73(95％CI:0.67 ～ 0.79).将BISAP和HAP评分相结合,2种评分均异常的患者发生不良结局的风险逐渐升高.结论 BISAP评分对AP预后的评估价值与Ranson评分相当,但更为简便.HAP评分能简单且准确地预测MAP的预后,BISAP和HAP评分相结合有助于更好地判断AP患者的预后.
目的 評價急性胰腺炎床徬嚴重度指數(BISAP)與無害性胰腺炎評分(HAPS)評估急性胰腺炎(AP)預後的價值.方法 迴顧性分析2003年1月至2010年12月中山大學附屬第一醫院收治的442例AP患者資料,計算BISAP和HAP評分,繪製受試者工作特徵(ROC)麯線併計算麯線下麵積(AUC),分析它們對AP嚴重度、跼部併髮癥、器官功能不全、預後的評估價值,併與傳統的Ranson評分進行比較.結果 442例AP患者中,73例(16.5％)為重癥急性胰腺炎(SAP).BISAP評分預測SAP、跼部併髮癥、器官功能不全、病死結跼的AUC分彆是0.90(95％ CI:0.86～ 0.93)、0.82(95％ CI:0.76～0.89)、0.93(95％ CI:0.89 ～0.96)、0.93(95％ CI:0.87 ～0.98).BISAP評分和Ranson評分上述4項指標的AUC差異無統計學意義.HAP評分預測輕癥急性胰腺炎(MAP)的特異性為85％,暘性預測值95％,AUC為0.73(95％CI:0.67 ～ 0.79).將BISAP和HAP評分相結閤,2種評分均異常的患者髮生不良結跼的風險逐漸升高.結論 BISAP評分對AP預後的評估價值與Ranson評分相噹,但更為簡便.HAP評分能簡單且準確地預測MAP的預後,BISAP和HAP評分相結閤有助于更好地判斷AP患者的預後.
목적 평개급성이선염상방엄중도지수(BISAP)여무해성이선염평분(HAPS)평고급성이선염(AP)예후적개치.방법 회고성분석2003년1월지2010년12월중산대학부속제일의원수치적442례AP환자자료,계산BISAP화HAP평분,회제수시자공작특정(ROC)곡선병계산곡선하면적(AUC),분석타문대AP엄중도、국부병발증、기관공능불전、예후적평고개치,병여전통적Ranson평분진행비교.결과 442례AP환자중,73례(16.5％)위중증급성이선염(SAP).BISAP평분예측SAP、국부병발증、기관공능불전、병사결국적AUC분별시0.90(95％ CI:0.86～ 0.93)、0.82(95％ CI:0.76～0.89)、0.93(95％ CI:0.89 ～0.96)、0.93(95％ CI:0.87 ～0.98).BISAP평분화Ranson평분상술4항지표적AUC차이무통계학의의.HAP평분예측경증급성이선염(MAP)적특이성위85％,양성예측치95％,AUC위0.73(95％CI:0.67 ～ 0.79).장BISAP화HAP평분상결합,2충평분균이상적환자발생불량결국적풍험축점승고.결론 BISAP평분대AP예후적평고개치여Ranson평분상당,단경위간편.HAP평분능간단차준학지예측MAP적예후,BISAP화HAP평분상결합유조우경호지판단AP환자적예후.
Objective To evaluate the bedside index for severity in acute pancreatitis (BISAP) and harmless acute pancreatitis (HAP) scoring system in predicting prognosis of acute pancreatitis (AP).Methods A total of 442 AP patients,who were admitted to The First Affiliated Hospital of Sun Yat-sen University from January 2003 to December 2010,were retrospectively studied.BISAP and HAP scores were evaluated respectively.The value of BISAP and HAP scores in predicting severity,local complications,organ failure and mortality were measured by the area under the curve (AUC) of receiver operator characteristic curve (ROC),and it was compared with that of traditional Ranson's score.Results Among 442 patients,73 patients (16.5％) were diagnosed to have severe acute pancreatitis (SAP).AUC for BISAP score in predicting SAP,local complications,organ failure and mortality were 0.90 (95％ CI:0.86 ～ 0.93),0.82(95％ CI:0.76 ～ 0.89),0.93 (95％ CI:0.89 ～ 0.96),0.93 (95％ CI:0.87 ～ 0.98).There were no statistically significant differences in AUCs of the four prognostic parameters between BISAP and Ranson's score.The specificity,positive predictive value (PPV),and AUC of HAP score in predicting mild AP were 85％,95％ and 0.73 (95％ CI:0.67 ～ 0.79).The risk of dismal prognosis increased when both BISAP and HAP score were abnormal.Conclusions BISAP and Ranson's score have comparable ability in predicting prognosis of patients with AP.However,BISAP score is simpler.HAP score is a simple and accurate method for predicting prognosis of patients with mild AP.Combination of BISAP score with HAP score can better help predict the prognosis of AP patients.
