摘要
目的比较急性生理学和慢性健康评分（APACHEⅡ）、Ranson评分、全身性感染相关性器官功能衰竭评分（SOFA）、BahhazarCT严重指数（CTSI）和改良早期预警评分（MEWS）五种临床常用评分系统对重症急性胰腺炎患者早期预后的预测价值。方法回顾性分析2004年1月至2010年1月收治的重症急性胰腺炎患者154例，记录所有患者入院后3d内的五种评分系统评分，按入院后生存时间又分为早期死亡组43例和早期存活组111例。比较两组入院后3d内五种评分系统的差异及对重症急性胰腺炎早期预后的预测价值。结果早期死亡组入院后3d内每天的五种评分系统评分均高于早期存活组，差异有统计学意义（P〈0．05或〈0．01）。在预测重症急性胰腺炎早期预后中人院后第1天APACHEⅡ的准确度和价值最大[曲线下面积（AUC）为0．879]，其次是MEWS（AUC为0．858），第2、3天MEWS的准确度和价值最大（AUC分别为0．900和0．942）。结论MEWS在预测重症急性胰腺炎早期预后的准确度和价值较高，值得临床推广。
objective To evaluate the prognostic value of five scoring systems including acute physiology and chronic health evaluation Ⅱ score (APACHE Ⅱ ),Ranson score,sepsis-related organ failure assessment (SOFA),Balthazar CT severity index (CTSI) and modified early warning score (MEWS) in early prognosis of severe acute pancreatis.Methods One hundred and fifty-four patients with severe acute pancreatitis from January 2004 to January 2010 were studied retrospectively,and data pertinent to five scoring systems were recorded from day 1 to day 3 after admission in hospital All patients were divided into early non-survival group (43 cases) and early survival group ( 111 cases) by survival time after admission in hospital.Five scoring systems during first 3 days aftter admission and their prognostic value in early prognosis of severe acute pancreatitis was compared between two groups.Results Compared with that of early survival group,every day five scoring systems of early non-survival group were significantly higher in the first 3 days after admission (P ＜ 0.05 or ＜ 0.01 ).On day 1 after admission,APACHE Ⅱ was the most accurate predict of early mortality with area under curve (AUC) value of 0.879,closely followed by MEWS (AUC 0.858).On day 2 and 3 after admission,the MEWS was the most accurate predict of early mortality with AUC 0.900 and 0.942,respectively.Conclusion MEWS is more accurate predict of early mortality in severe acute pancreatitis among different scoring systems,worthy of generalization in clinic.
出处
《中国医师进修杂志》
2011年第28期28-31,共4页
Chinese Journal of Postgraduates of Medicine
