APACHE Ⅱ评分、Ranson评分及EPIC评分对急性胰腺炎预后评价的比较——附198例报告  

A comparative study on acute physiology and chronic health evaluation Ⅱ score,Ranson score and extrapancreatic inflammation on abdominal computed tomography score in predicting outcomes of patients with acute pancreatitis

作　　者：李雅洁[1] 黄智铭[1] 陶利萍[1] 洪万东[1] 

机构地区：[1]浙江温州医学院附属第一医院消化内科,325000

出　　处：《新医学》2009年第11期716-718,共3页Journal of New Medicine

摘　　要：目的:比较急性生理学及慢性健康状况Ⅱ(acute physiology and chronichealth evaluationⅡ,APACHEⅡ)评分、Ranson评分及腹部CT胰腺外炎症(extrapancreaticinflammation on abdominal computed tomography,EPIC)评分预测急性胰腺炎(acute pancreati-tis,AP)预后的价值。方法:临床资料完整的AP患者198例,其中确诊为重症急性胰腺炎(severe acute pancreatitis,SAP)60例,轻症急性胰腺炎(mild acute pancreatitis,MAP)138例,采用受试者工作特性曲线分析APACHEⅡ评分、Ranson评分、EPIC评分预测AP的病情严重程度、并发症的价值。结果:198例患者中,SAP和MAP患者APACHEⅡ评分、Ranson评分、EPIC评分分值比较差异有统计学意义(均为P<0.01)。EPIC评分标准判断SAP的敏感度、特异度最高,曲线下面积最大,且其预测局部并发症的曲线下面积最大,而APACHEⅡ评分预测全身并发症的曲线下面积最大。结论:对入院24 h内的AP患者,EPIC评分结合APACHEⅡ评分能有效预测其预后,而Ranson评分不具优势。Objective： To compare the value of acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） score, Ranson score and extrapancreatic inflammation on abdominal computed tomography （EP- IC） score in predicting outcomes of patients with acute pancreatitis（AP）. Methods： One hundred and ninety-eight patients diagnosed as AP with completed data were studied. Among 198 patients, sixty were severe acute pancreatitis （SAP） and others were mild acute pancreatitis（MAP）. The value of APACHE Ⅱ score, Ranson score and EPIC score were assessed using by receiver operator characteristic （ROC） curve in predicting severity and complications of AP. Results： Among 198 patients, the APACHE Ⅱ score, Ranson score and EPIC score were significantly higher in SAP group than those in MAP group（all P 〈0. 01 ）. EPIC score had the best sensitivity, specificity and the area under ROC curve （AUROC） for predicting SAP, and had the greatest AUROC to predict local complications. However, the APACHE Ⅱ score had the greatest AUROC to predict systemic complications. Conclusion ： In patients with AP, combined EPIC score and APACHE Ⅱ score can estimate outcomes accurately within 24 h of admission, but the Ranson score has no advantages.

关 键 词：急性胰腺炎 急性生理学及慢性健康状况Ⅱ评分 RANSON评分 腹部CT胰腺外炎症评分 急性胰腺炎 重症 预后 

分 类 号：R576[医药卫生—消化系统] R657.51[医药卫生—内科学]