目的:研究BISAP(bedside index for severity in AP)评分联合凝血指标对急性胰腺炎(acute pancreatitis,AP)严重程度评估的意义.方法:回顾2008-2012年中国医科大学附属盛京医院收治的166例AP患者的临床资料.对所有患者进行入院24h的BISA...目的:研究BISAP(bedside index for severity in AP)评分联合凝血指标对急性胰腺炎(acute pancreatitis,AP)严重程度评估的意义.方法:回顾2008-2012年中国医科大学附属盛京医院收治的166例AP患者的临床资料.对所有患者进行入院24h的BISAP、APACHE-Ⅱ评分,48h的Ranson's及发病72h内CTSI评分,入院24h内抽取静脉血测定部分凝血活酶活化时间、凝血酶原时间、D-二聚体(D-dimer)、纤维蛋白原及血小板水平.分析凝血指标及BISAP评分对AP严重程度判断的意义,并通过ROC曲线分析二者联合对AP严重程度评估的意义.结果:多因素Logistic回归分析发现,D-dimer对AP严重程度评估具有独立预测意义;随着BISAP评分增加,SAP的比率增加;BISAP评分系统评估AP严重程度以2为临界点时Youden指数最大(0.541),ROC曲线下面积为0.836(0.776-0.896),并不逊于传统评分系统;BISAP评分系统联合D-dimer能更好地评估AP患者的严重程度.结论:BISAP是临床判断AP轻重程度的简单有效的指标,将BISAP与D-dimer联合应用使得对AP严重程度的评估更为准确.展开更多
目的:探讨BISAP评分联合血清胆碱酯酶对危重型急性胰腺炎(acute pancreatitis,AP)的诊断价值。方法:选取2014年1月至2016年6月重庆市急救医疗中心收治的164例AP患者,其中轻型52例,中型76例,重型16例,危重型20例。比较不同分类AP的BISAP...目的:探讨BISAP评分联合血清胆碱酯酶对危重型急性胰腺炎(acute pancreatitis,AP)的诊断价值。方法:选取2014年1月至2016年6月重庆市急救医疗中心收治的164例AP患者,其中轻型52例,中型76例,重型16例,危重型20例。比较不同分类AP的BISAP评分及血清胆碱酯酶水平。同时,利用受试者工作曲线下面积(area under the curve,AUC)预测危重型AP,并比较BISAP评分及血清胆碱酯酶联合诊断与单独应用的差异性。结果:随着AP患者病情严重程度的增加,BISAP评分逐渐升高,血清胆碱酯酶水平逐渐下降。4种AP患者的BISAP评分和血清胆碱酯酶水平比较,差异有统计学意义(均P<0.05)。BISAP评分诊断危重型AP的AUC为0.881(95%CI:0.795~0.968),最佳截断值为2.5分,此时敏感性为90.0%,特异性为79.2%,准确性为80.5%。血清胆碱酯酶诊断危重型AP的AUC为0.791(95%CI:0.668~0.914),最佳截断值为3 406 U/L,此时敏感性为85.0%、特异性为74.3%,准确性为75.6%。通过logistic回归得出BISAP评分和血清胆碱酯酶回归模型,预测危重型AP的AUC为0.935(95%CI:0.892~0.978),敏感性为95.0%,特异性为88.2%,准确性为89.0%。联合诊断的AUC面积大于BISAP评分或血清胆碱酯酶单独诊断的AUC面积,差异有统计学意义(均P<0.05)。结论:BISAP评分和血清胆碱酯酶均能较准确地诊断危重型AP,二者联合诊断时可以进一步提高诊断效能。展开更多
This paper analyzes the first differences of the annual means (annual rate) for the Y and Z components of the geomagnetic field from nine magnetic observatories in China, measured from 1985 to 2003. The 1991 jerk was ...This paper analyzes the first differences of the annual means (annual rate) for the Y and Z components of the geomagnetic field from nine magnetic observatories in China, measured from 1985 to 2003. The 1991 jerk was obvious in the Y component measured but not clear for the Z component. Rapid changes in the Z components were ubiquitous around 2000-2001, but not seen for the Y component. External effects were removed from the monthly means by comparing the monthly mean of the geomagnetic field components at the observatories with the monthly time series of the A_p geomagnetic index. However, some examples were analyzed and showed whether external effects were removed or not, there was no marked distinction in determining the jerks in China for the Y component and the Z component of the geomagnetic field. Finally, the isolines of the first differences of the annual means were used to analyze the spatial and temporal distributions of the jerks.展开更多
文摘目的:研究BISAP(bedside index for severity in AP)评分联合凝血指标对急性胰腺炎(acute pancreatitis,AP)严重程度评估的意义.方法:回顾2008-2012年中国医科大学附属盛京医院收治的166例AP患者的临床资料.对所有患者进行入院24h的BISAP、APACHE-Ⅱ评分,48h的Ranson's及发病72h内CTSI评分,入院24h内抽取静脉血测定部分凝血活酶活化时间、凝血酶原时间、D-二聚体(D-dimer)、纤维蛋白原及血小板水平.分析凝血指标及BISAP评分对AP严重程度判断的意义,并通过ROC曲线分析二者联合对AP严重程度评估的意义.结果:多因素Logistic回归分析发现,D-dimer对AP严重程度评估具有独立预测意义;随着BISAP评分增加,SAP的比率增加;BISAP评分系统评估AP严重程度以2为临界点时Youden指数最大(0.541),ROC曲线下面积为0.836(0.776-0.896),并不逊于传统评分系统;BISAP评分系统联合D-dimer能更好地评估AP患者的严重程度.结论:BISAP是临床判断AP轻重程度的简单有效的指标,将BISAP与D-dimer联合应用使得对AP严重程度的评估更为准确.
文摘目的:探讨BISAP评分联合血清胆碱酯酶对危重型急性胰腺炎(acute pancreatitis,AP)的诊断价值。方法:选取2014年1月至2016年6月重庆市急救医疗中心收治的164例AP患者,其中轻型52例,中型76例,重型16例,危重型20例。比较不同分类AP的BISAP评分及血清胆碱酯酶水平。同时,利用受试者工作曲线下面积(area under the curve,AUC)预测危重型AP,并比较BISAP评分及血清胆碱酯酶联合诊断与单独应用的差异性。结果:随着AP患者病情严重程度的增加,BISAP评分逐渐升高,血清胆碱酯酶水平逐渐下降。4种AP患者的BISAP评分和血清胆碱酯酶水平比较,差异有统计学意义(均P<0.05)。BISAP评分诊断危重型AP的AUC为0.881(95%CI:0.795~0.968),最佳截断值为2.5分,此时敏感性为90.0%,特异性为79.2%,准确性为80.5%。血清胆碱酯酶诊断危重型AP的AUC为0.791(95%CI:0.668~0.914),最佳截断值为3 406 U/L,此时敏感性为85.0%、特异性为74.3%,准确性为75.6%。通过logistic回归得出BISAP评分和血清胆碱酯酶回归模型,预测危重型AP的AUC为0.935(95%CI:0.892~0.978),敏感性为95.0%,特异性为88.2%,准确性为89.0%。联合诊断的AUC面积大于BISAP评分或血清胆碱酯酶单独诊断的AUC面积,差异有统计学意义(均P<0.05)。结论:BISAP评分和血清胆碱酯酶均能较准确地诊断危重型AP,二者联合诊断时可以进一步提高诊断效能。
基金sponsored by the Earthquake Scientific Research Program(200708043),China
文摘This paper analyzes the first differences of the annual means (annual rate) for the Y and Z components of the geomagnetic field from nine magnetic observatories in China, measured from 1985 to 2003. The 1991 jerk was obvious in the Y component measured but not clear for the Z component. Rapid changes in the Z components were ubiquitous around 2000-2001, but not seen for the Y component. External effects were removed from the monthly means by comparing the monthly mean of the geomagnetic field components at the observatories with the monthly time series of the A_p geomagnetic index. However, some examples were analyzed and showed whether external effects were removed or not, there was no marked distinction in determining the jerks in China for the Y component and the Z component of the geomagnetic field. Finally, the isolines of the first differences of the annual means were used to analyze the spatial and temporal distributions of the jerks.
