摘要
目的比较PANC3、SIRSS、HAPS、Ranson’s、CTSI评分对急性胰腺炎(acute pancreatitis,AP)病情严重程度的评估价值,为AP诊治、改善预后提供临床依据。方法回顾性分析昆明医科大学第二附属医院消化内科2013年1月至2016年12月收治的121例AP患者临床资料,计算PANC3、SIRSS、HAPS、Ranson’s、CTSI评分,绘制受试者工作特征曲线(ROC),比较各评分对SAP、局部并发症、全身并发症、死亡的预测价值。结果 MAP组、MSAP组及SAP组5种评分均数比较,差异均有统计学意义(P均<0.05),SAP组分值显著高于MAP组及MSAP组;PANC3、SIRSS、HAPS、Ranson’s、CTSI评分与AP病情严重程度有显著相关性(P<0.05),HAPS评分与SAP无相关性(P>0.05),HAPS评分预测MAP的准确度为90.5%。对预测SAP方面,PANC3评分AUC值、约登指数、敏感度高于其他评分。在预测AP局部并发症方面,CTSI评分AUC值、约登指数、敏感度和特异度高于其他评分。在预测AP全身并发症和死亡方面,Ranson’s评分AUC值、约登指数均高于其他评分。在评估局部并发症、全身并发症、死亡的发生率方面,PANC3≥2分、SIRSS≥2分、Ranson’s≥3分、CTSI≥4分组所占例数均显著高于PANC3<2分、SIRSS<2分、Ranson’s<3分、CTSI<4分组。结论 Ranson’s评分对预测AP全身并发症和死亡率的诊断价值及准确度高于其他评分,在预测AP局部并发症中CTSI评分诊断价值有显著优势,PANC3评分对预测SAP诊断价值优于其他评分,HAPS对评价MAP准确度更高。
Objective To compare the value assessment of the PANC3,SIRSS,HAPS,Ranson＇s,CTSI scores in severity of acute pancreatitis（ AP） and to provide clinical basis for the diagnosis,treatment and improve prognosis of AP. Methods Clinical data of 121 patients with AP in Department of Gastroenterology,the Second Affiliated Hospital of Kunming Medical University from Jan. 2013 to Dec. 2016 were analyzed retrospectively. The PANC3,SIRSS,HAPS,Ranson＇s,CTSI scores were calculated. The receiver operating characteristic curve（ ROC） of scoring systems was drawn,the value of severity of disease prediction,local complications,systemic complications and mortality were compared. Results There were statistically significant differences in 5 average scores among MAP group,MSAP group and SAP group（ P〈0. 05）. The 5 average scores in SAP group were significantly higher than those in MAP group and MSAP group. PANC3,SIRSS,Ranson＇s,CTSI score were significantly correlated with the severity of AP（ P〈0. 05）,and the HAPS score was not correlated with severity（ P〈0. 05）. The accuracy of HAPS score in predicting MAP was90. 5%. The AUC Youden index,sensitivity of PANC3 score were higher than the other scores in the prediction of SAP.To determine the AP local complications,CTSI score＇s AUC value and Youden index,sensitivity and specificity were significantly higher than the other scores. The AUC,Youden index,sensitivity of Ranson＇s score were the highest in predicting systemic complication and mortality of AP. In the incidence of AP,local complications,systemic complications,mortality,the percentages were significantly higher in PANC3 ≥2,SIRSS≥2,Ranson＇s≥3,CTSI≥4 groups than those in PANC3 2,SIRSS 2,Ranson＇s 3,CTSI 4 groups. Conclusion The Ranson＇s score is significantly higher than the other scoring criteria in predicting systemic complications and mortality of AP. The value of CTSI score in predicting local complications of AP has significant advantages. The PANC3 score is better than the other scores in predicting SAP,and the HAPS is highly accurate in the evaluation of MAP.
出处
《胃肠病学和肝病学杂志》
CAS
2018年第1期25-29,共5页
Chinese Journal of Gastroenterology and Hepatology
关键词
急性胰腺炎
评分系统
并发症
死亡率
诊断价值
Acute pancreatitis
Scoring system
Complications
Mortality
Diagnostic value
