BISAP与Ranson's评分对急性胰腺炎患者预后评估的比较  

BISAP score vs Ranson's criteria in predicting outcomes of acute pancreatitis

作　　者：周圆圆[1] 杨丽[1] 廖忠莉[1] 宁琳洪[1] 郭红[1] 赵晓晏[1] 

机构地区：[1]第三军医大学新桥医院消化内科,重庆400037

出　　处：《第三军医大学学报》2012年第7期658-661,共4页Journal of Third Military Medical University

摘　　要：目的比较BISAP评分与Ranson’s评分在预测急性胰腺炎(acute pancreatitis,AP)的严重度及病死率方面的运用价值。方法以2007年6月到2010年10月入住本院的AP患者为研究对象,资料完整诊断明确者共有652例,采用BISAP(the bedside index for severity in AP)评分与Ranson’s评分比较,受试者工作特性曲线(receiver-operating curve,ROC)行回顾性分析,在预计AP的严重度及病死率方面的差异。结果在652例患者中,通过发病48 h内出现器官衰竭确定为重症者108例(16.6%),共死亡21例(3.2%),BISAP评分≥3分的44例(6.7%),入院48 h内Ranson’s评分≥3分者213例(32.7%)。BISAP与Ranson’s评分二者在评价预后方面的差异有统计学意义,其中严重度的曲线下面积BISAP、Ranson’s评分系统分别为:0.846(95%CI 0.808～0.883),0.771(95%CI 0.722～0.820);死亡率分别是:0.809(95%CI 0.699～0.920),0.762(95%CI 0.638～0.885)。结论 BISAP评分系统在急性胰腺炎早期,针对患者严重度、死亡率的预后评估的准确性明显高于Ranson’s评分,是目前最简易、及时、连续性强并且对患者而言经济花费少的评分系统,可在临床广泛推广。Objective To evaluate the clinical values of the bedside index for severity in acute pancreatitis（BISAP） and Ranson＇s criteria in predicting severity and mortality in patients with AP.Methods Six hundreds and fifty-two patients with AP,who were admitted into our department from June 2007 to October 2010 were enrolled retrospectively.The receiver-operating curve（ROC） of BISAP and Ranson systems were compared in assessing severity and mortality in these AP patients.Results Among these 652 patients,there were 108 cases classified as severe AP,21 cases died（3.2%）,44 cases with BISAP score ≥3（6.7%）,and 213 cases with Ranson score ≥3 within 48 h hospitalization（32.7%）.The area under the receiver-operating curve（AUC） for severity by BISAP and Ranson＇s were 0.846（95%CI 0.808 to 0.883）,and 0.771（95%CI 0.722 to 0.820） respectively（P0.05）.The AUC for mortality by BISAP and Ranson were 0.809（95%CI 0.699 to 0.920）,and 0.762（95%CI 0.638 to 0.885） respectively（P0.05）.Conclusion BISAP score system is a more accurate and dynamic method to early predict severity and mortality in AP than Ranson＇s criteria.BISAP is a simple,prompt,economical,and ideal prognosis scoring system in clinical practice.

关 键 词：BISAP评分 Ranson’s评分 急性胰腺炎 预后 

分 类 号：R449[医药卫生—诊断学] R576[医药卫生—临床医学]