摘要
目的比较APACHEⅡ、Ranson和CT 3种临床常用评分系统对重症急性胰腺炎(SAP)预后指标的预测作用。方法回顾分析1993年1月-2004年1月收治的201例SAP患者。记录资料包括24 h APACHEⅡ评分、48 h APACHEⅡ评分、48 h Ranson评分和72 h CT评分。预后指标包括:胰腺坏死程度、局部并发症、感染、器官衰竭、外科引流、死亡率、禁食天数和住院天数。应用ROC曲线下面积(AUC)检验各评分数据对预后预测的价值。结果通过比较AUC,在预测器官衰竭和禁食天数方面, APACHEⅡ(48 h)具有优越性。在预测局部并发症,禁食天数以及住院天数方面,Ranson评分相对较好。较之其他评分系统,CT评分在预测胰腺坏死和外科引流方面有较大优势。结论对上述8个预测指标,几种评分系统的评价预测能力不相同。应当联合应用几种评分系统评价SAP患者的预后。
Objective To evaluate the prognostic ability of three different scoring systems （four group scores）, which are very useful in clinic, and the relations between prognostic variables and scoring systems. Methods 201 patients with acute severe pancreatitis, who were admitted into Changhai Hospital from January 1993 to January 2004, were studied retrospectively. Data pertinent to scoring systems were recorded 24 hours （APACHE Ⅱ score）, 48 hours （APACHE Ⅱ and Ranson scores） and 72 hours （Balthazar computed tomography severity index） after admission. The prognostic variables include ： pancreatic necrosis, local complications, infection, and development of organ failure, surgery drainage, death, and the days of food prohibition and in hospital. Statistical analysis was performed by using receiver operating characteristic curves and by logistic regression for all eight outcome variables. Results Through compared AUC, in organ failure and days of food prohibition prediction, APACHE Ⅱ （48 h） score was superior. In predicting local complications, the days of food prohibition and in hospital, Ranson score was proper to be recommended. CT score performed obviously better than other scores in pancreatic necrosis and surgery drainage prediction. Conclusions For every eight outcome variables, the prognostic ability of different scoring systems was not same. Several scoring systems should combine to predict the outcome of severe acute pancreatitis.
出处
《胰腺病学》
2006年第4期196-200,共5页
Chinese JOurnal of Pancreatology
作者简介
通信作者：李兆申，Email：zhsl@81890．net
