摘要
目的探讨PASS评分、BISAP评分、APACHE-Ⅱ评分、HAPS评分和Ranson评分五种评分系统对高甘油三酯血症性急性胰腺炎(HTGAP)病情和预后评估的价值。方法回顾性分析宁夏医科大学总医院2016年1月—2022年1月收治的300例HTGAP患者的临床资料,根据患者病情程度分为轻症急性胰腺炎、中度重症急性胰腺炎、重症急性胰腺炎三个组别,比较三组患者的临床资料和评分系统差异,计数资料组间比较采用χ^(2)检验,正态方差齐的计量资料采用方差分析,非正态分布的计量资料三组间比较采用Kruskal-Wallis H检验。根据病情程度是否重症,绘制受试者工作特征曲线(ROC曲线),比较指标的ROC曲线下面积(AUC)。结果三组间PASS评分(χ^(2)=219.351)、Ranson评分(χ^(2)=83.084)、APACHE-Ⅱ评分(χ^(2)=43.388)和BISAP评分(χ^(2)=50.785)差异均有统计学意义(P值均<0.01)。在病情严重程度的评估和预测方面,PASS评分的敏感度(0.945)和AUC(0.963)高于其他四种评分系统,Ranson评分的敏感度(0.655)和AUC(0.819)次之。结论对于HTGAP患者,PASS评分可以更准确地评估HTGAP患者的病情严重程度及预后,有望在临床中更好的推广应用。
Objective To investigate the value of pancreatitis activity scoring system(PASS)score,Bedside Index for Severity in Acute Pancreatitis(BISAP)score,Acute Physiology and Chronic Health EvaluationⅡ(APACHE-Ⅱ)score,harmless acute pancreatitis score(HAPS),and Ranson score in evaluating the severity and prognosis of hypertriglyceridemia acute pancreatitis(HTGAP).Methods A retrospective analysis was performed for the clinical data of 300 patients with HTGAP who were admitted to General Hospital of Ningxia Medical University from January 2016 to January 2022,and according to the disease severity,these patients were divided into mild acute pancreatitis(MAP)group,moderate-severe acute pancreatitis(MSAP)group,and severe acute pancreatitis(SAP)group.Clinical data and the above scores were compared between the three groups.The chi-square test was used for comparison of categorical data between groups;an analysis of variance was used for continuous data with homogeneity of variance,and the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between groups.The receiver operating characteristic(ROC)curve was plotted according to disease severity,and related indicators were compared in terms of the area under the ROC curve(AUC).Results There were significant differences between the three groups in PASS score(F=219.351,P<0.01),Ranson score(χ^(2)=83.084,P<0.01),APACHE-Ⅱscore(χ^(2)=43.388,P<0.01),and BISAP score(χ^(2)=50.785,P<0.01).Compared with the other four scoring systems in evaluating and predicting disease severity,PASS score had the highest sensitivity of 0.945 and the largest AUC of 0.963,followed by Ranson score with a sensitivity of 0.655 and an AUC of 0.819.Conclusion For patients with HTGAP,PASS score can more accurately assess the severity and prognosis of HTGAP patients and thus holds promise for clinical application.
作者
王鵷臻
员雅玲
谢娟
黄李雅
WANG Yuanzhen;YUN Yaling;XIE Juan;HUANG Liya(Department of Gastroenterology,General Hospital of Ningxia Medical University,Ningxia 750004,China;Department of Gastroenterology,Cardiovascular and Cerebrovascular Disease Hospital,General Hospital of Ningxia Medical University,Ningxia 750004,China)
出处
《临床肝胆病杂志》
CAS
北大核心
2023年第6期1391-1397,共7页
Journal of Clinical Hepatology
基金
国家自然科学基金(82260572)
宁夏自然科学基金(2023AAC03575)。
