摘要
目的对比Ranson评分、BahhazarCT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（acutepancreatitis，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EOR（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EoR（95％CI）为61．54（35．09～87．99）]优于Ranson[OR（95％CI）为46．15（19．05～73．25）]及CTSIEOR（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。
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 Bahhazar CTS1 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 bi[iary 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 % C1 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.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2012年第9期593-597,共5页
Chinese Journal of Digestion
