摘要
目的探讨入院早期序贯器官衰竭估计评分(SOFA)联合红细胞分布宽度(RDW)对急性胰腺炎(AP)短期预后的预测价值。方法选取合肥市第二人民医院2016年12月—2021年4月收治的79例AP患者作为研究对象,患者入院后,均接受AP相关治疗,根据治疗5 d后的临床疗效,将痊愈、好转患者归入预后良好组(n=65),无效患者归入预后不良组(n=14)。比较预后良好组与预后不良组入院早期SOFA评分、RDW等临床资料,多因素Logistic回归分析探讨影响AP患者短期预后的因素,Pearson相关性分析研究入院早期SOFA评分、RDW与急性生理与慢性健康评分(APACHEⅡ)的相关性,受试者工作特征(ROC)曲线评估入院早期SOFA评分、RDW对AP患者短期预后的预测价值。结果预后不良组APACHEⅡ评分,入院早期SOFA评分,RDW,尿素氮高于预后良好组,血小板计数低于预后良好组(均P<0.05);多因素Logistic回归分析结果显示APACHEⅡ评分,入院早期SOFA评分,RDW是AP预后的独立危险因素(OR=7.114,4.280,2.284,P<0.05);入院早期SOFA评分,RDW均与APACHEⅡ评分正相关(r=0.836,0.594,P<0.05);入院早期SOFA评分、RDW、二者联合预测AP患者短期预后的曲线下面积(AUC)分别为0.761(95%CI=0.617~0.905)、0.701(95%CI=0.523~0.867)、0.785(95%CI=0.750~1.000);入院早期SOFA评分联合RDW的AUC大于单独入院早期SOFA评分、RDW的AUC(P<0.05)。结论治疗无效的AP患者入院早期SOFA评分、RDW更高,入院早期SOFA评分、RDW是AP患者不良临床结局的独立影响因素,在预测患者短期预后中具有较高价值。
Objective To explore the predictive value of the sequential organ failure assessment score(SOFA)measured at the early stage of admission combined with red blood cell distribution width(RDW)for the short-term prognosis of acute pancreatitis(AP).Methods 79 AP patients were admitted and received conventional AP-related treatment.Five days later,they were divided into 2 groups according to the clinical efficacy:good prognosis group(n=65)who were recovered or improved and poor prognosis group(n=14)who failed to show improvement.General clinical data,including acute physiologic assessment and chronic health evaluation(APACHEⅡ)score,were collected.Multivariate Logistic regression analysis was used to explore the factors affecting the short-term prognosis of AP.The correlation of early admission SOFA score and RDW with APACHEⅡscore was studied by Pearson correlation analysis.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of early admission SOFA score and RDW for the short-term prognosis of AP.Results The levels of APACHEⅡscore,early admission SOFA score,RDW,and urea nitrogen of the poor prognosis group were all significantly higher than those of the good prognosis group,and the platelet count of the poor prognosis group was significantly lower than that of the good prognosis group(all P<0.05).The results of multivariate logistic regression analysis showed that APACHEⅡscore,early admission SOFA score,and RDW were all independent risk factors for the prognosis of AP(OR=7.114,4.280,2.284,P<0.05).Early admission SOFA score and RDW were both positively correlated with APACHEⅡscore(r=0.836,0.594,P<0.05).The area under the curve(AUC)measurements of early admission SOFA score,RDW,and the combination of the two were 0.761(95%CI=0.617~0.905),0.701(95%CI=0.523~0.867),and 0.785(95%CI=0.750~1.000)respectively.The AUC of early admission SOFA score combined with RDW was significantly larger than those of early admission SOFA score and RDW alone(both P<0.05).Conclusion The early admission SOFA score and RDW of the AP patients who fail to respond to treatment are significantly higher.The early admission SOFA score and RDW are independent factors influencing the adverse clinical outcome of AP patients,and have a high value in predicting the short-term prognosis of patients.
作者
陈良
蔡兆辉
魏国峰
李海山
CHEN Liang;CAI Zhaohui;WEI Guofeng;LI Haishan(Department of Emergency,The Second People's Hospital of Hefei,Hefei Hospital Affiliated to Anhui Medical University,Hefei Anhui 230011,China)
出处
《中国急救复苏与灾害医学杂志》
2023年第2期216-219,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
安徽省医学会急诊临床研究项目(编号:KY2018012)。
关键词
序贯器官衰竭估计评分
红细胞分布宽度
急性胰腺炎
短期预后
Sequential organ failure estimation score
Red blood cell distribution width
Acute pancreatitis
Shortterm prognosis
