摘要
目的观察床旁严重度指数（BISAP）评分联合C反应蛋白（CRP）对急性胰腺炎（AP）预后的早期预测价值。方法对近2年河北省人民医院收治的114例AP患者作回顾性分析，测定24h血淀粉酶、血糖、血钙、CRP、D．二聚体水平，根据评分标准进行BISAP、急性生理和慢性健康评估（APACHEⅡ）、Ranson’s、BalthazarCT严重指数（CTSI）评分，比较BISAP评分各分值中轻度AP（MAP）、中度AP（MSAP）、重度AP（SAP）、死亡人数及所占比例；BISAP评分与实验室指标的相关性研究；CRP与各种评分的相关性研究；比较BISAP评分联合CRP与其他评分系统对SAP的预测价值。结果随着BISAP分值的升高，患者病情的严重程度及死亡人数均有明显差异（X2=78．616，P〈0．01）；BISAP评分与CRP、D．二聚体、血糖呈正相关（r分别是0．451、0．329、0．241，P〈0．01），与血钙呈负相关（r=-0．315，P〈0．01）；CRP与APACHE．11、Ranson’8、BISAP及CTSI评分呈正相关（r分别是0．407、0．392、0．451、0．427，P〈0．001）；将CRP纳入BISAP评分，预测SAP的曲线下面积（AUC）为0．873，预测死亡的AUC为0．909，BISAP评分联合CRP对AP患者的病情严重程度和死亡有很好的预测价值。结论BISAP评分方法简便，对AP的严重程度有很好的预测价值；BISAP联合CRP能更好的预测AP的预后。
Objective To explore the early evaluations of Bedside Index for Severity in Acute Pancreatitis （BISAP） plus C-reactive protein （CRP） in predicting the severity and prognosis of acute pancreatitis （AP）. Methods A total of 114 cases of AP at our hospital over the last 2 years were retrospectively analyzed. The levels of amylase, serum glucose, serum calcium, CRP and D-dimer in 24 hours were measured. According to the evaluation standard, the scores of BISAP, acute physiology and chronic health evaluation （APACHE II ） , Ranson and computed tomography severity index （CTSI） were obtained. Mild acute pancreatitis （MAP）, moderately severe acute panereatitis （MSAP）, severe acute pancreatitis （SAP） , death toll and their proportion were compared in different BISAP scores. Correlation analyses were conducted for BISAP scores and laboratory indices, CRP and different scoring systems. We compared the evaluative value of BISAP plus CRP and other scoring systems in SAP. Results With rising BISAP scores, both severity and mortality increased in acute panereatitis（ X2 = 78. 616, P 〈 0. 01 ）. BISAP scores were positively correlated with CRP, D-dimer and serum glucose （ r = 0. 451,0O. 329, 0. 241, P 〈 0. 01 ） and negatively correlated with serum calcium （ （ r = - 0. 315, P 〈 0. 01 ）. CRP was positively correlated with APACHE- Ⅱ, Ranson＇s, BISAP and CTSI scores （r = O. 407, 0. 392, 0. 451, 0. 427, P 〈 0. 001 ）. When CRP was included into the BISAP scores, the area under the curve （AUC） of predicting SAP was O. 873 and the AUC of predicting death O. 909 so that BISAP score plus CRP had a good predictive value for the severity of AP and death. Conclusion In clinical practice, the simple BISAP scoring system may predict the severity of AP. And BISAP score plus CRP has a better predictive value for AP.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2015年第12期925-928,共4页
National Medical Journal of China
基金
河北省卫生厅指令课题项目（20130106）
关键词
BISAP评分
C反应蛋白
胰腺炎
预后
BISAP scoring system
C- reactive protein
Pancreatitis
Prognosis
