摘要
目的比较APACHEⅡ评分、Ranson评分及改良Ranson评分对胆源性急性胰腺炎严重程度及其预后评估的临床价值。方法回顾并分析328例胆源性急性胰腺炎患者的病历资料,进行APACHEⅡ评分、改良Ranson评分及Ranson评分。应用ROC曲线分析比较3种评分系统预测胆源性急性胰腺炎严重程度及其评估预后的能力。结果 328例胆源性急性胰腺炎中诊断为重症急性胰腺炎(SAP)72例,轻症急性胰腺炎(MAP)256例,SAP和MAP组的年龄、性别构成差异无统计学意义(P>0.05);各评分系统的分值数据两两相关;改良Ranson评分预测胆源性急性胰腺炎严重程度较APACHEⅡ评分及Ranson评分有优势,在SAP中预测胰腺坏死的发生较APACHEⅡ评分有优势。改良Ranson评分预测胆源性SAP的最佳cut-off值为2,其敏感性为81.94%、特异性为75.78%、阳性预测值为48.8%、阴性预测值为93.7%。结论改良Ranson评分较APACHEII及Ranson评分系统对胆源性急性胰腺炎严重程度的预测有一定的优势。
Objective To evaluate and compare clinical significances of biliary Ranson score,APACHE Ⅱ score and Ranson score in predicting the severity of biliary acute panereatitis and its prognosis. Methods The clinical data of 328 patients with biliary panereatitis were studied retrospectively. The APACHE Ⅱ score was calculated in the first 24 hours after admission, so were Ranson and the biliary Ranson scores within 48 hours after admission. The receive operating characteristic （ROC）eurve analysis was used to evaluate the ability of biliary Ranson score and other scoring systems in predicting the severity of biliary pancreatitis, the occurrence of pancreatic necrosis and mortality and organ failure. Results Seventy-two patients were diagnosed as severe acute pancreatitis （SAP） and 256 patients were mild acute ＂panereatitis （MAP） in 328 patients with biliary pancreatitis. There were no significant differences in age and gender between SAP and MAP groups. The scores were correlated significantly between every two systems, respectively. The biliary Ranson score was more useful in predicting SAP than APACHEⅡ score and Ranson score. The biliary Ranson score can perform better in predicting pancreatic necrosis in patients with SAP compared to that of APACHE Ⅱ score. The cutoff Value of biliary Ranson score in predicting SAP was 2, in which the sensitivity, specificity, positive predictive value （PPV） and negative predictive value （NPV） were 81.94%, 75.78%, 48.8% and 93.7%, respectively. Conclusion The biliary Ranson score is a more valuable score than other scores in predicting the severity of biliary pancreatitis.
出处
《天津医药》
CAS
北大核心
2013年第1期37-40,共4页
Tianjin Medical Journal
