高脂血症性急性胰腺炎严重程度的早期评估  

Early assessment of the severity of hyperlipidemic acute pancreatitis

作　　者：刘盛兰 陆士奇[1] 

机构地区：[1]苏州大学附属第一医院急诊ICU,江苏苏州215021

出　　处：《中国急救医学》2014年第3期230-233,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨急性胰腺炎严重程度床边指数（BISAP）评分系统及甘油三酯（TG）、胆固醇（TC）、纤维蛋白原（FIB）、C反应蛋白（CRP）等指标在高脂血症性急性胰腺炎（HLAP）严重程度早期评估中的价值。方法选取2009一01～2012—12本院急诊收治的42例HLAP患者作为研究对象，完善相关实验室检查及腹部增强CT检查，对其分别进行BISAP、APACHEII、Ranson以及CTSI评分。比较BISAP评分与其余3种评分系统的重症胰腺炎筛出率的差异，分别以BISAP评分和APACHEII评分将42例HLAP患者分为轻型急性胰腺炎（MAP）和重型急性胰腺炎（SAP）两组，比较各组间TG、TC、FIB、CRP的差异，并分别与BISAP评分和APACHEII评分进行Spearman相关性分析。结果BISAP、APACHE1I、Ranson以及CTSI评分SAP筛出率分别为54．8％、59．5％、54．8％、50．0％，BISAP评分系统与APACHElI、Ranson以及CTSI评分比较，对SAP筛出率差异无统计学意义（P〉0．05）；在分别以BISAP和APACHEII评分分组比较中，TG、FIB、CRP在SAP组均高于MAP组（P〈0．05），FIB、CRP与BISAP评分和APACHElI评分具有相关性，TG、TC与BISAP评分和APACHEII评分无相关性。结论BISAP评分系统具有与传统评分方法接近的SAP筛出率，是临床评估HLAP严重程度简单而有效的工具，可进一步推广应用，监测FIB、CRP等指标对于早期评估HLAP严重程度具有一定的价值。Objective This study was designed to investigate the early assessment value of bedside index for severity in acute pancreatitis （BISAP） and levels of triglyeerides （TG）, total cholesterol （ TC ） , fibrinogen （ FIB ） , C - reactive protein （CRP） in the prediction of severity in hyperlipidemic pancreatitis. Methods From January 2009 to December 2012, 42 patients of hyperlipidemic pancreatitis from emergency department were admitted to the study, and were divided into 2 groups： mild acute pancreatitis （MAP） group and severe acute pancreatitis （SAP） group. The BISAP score and the serum concentrations of TG, TC, FIB and CRP were compared between the two groups. Spearman correlation analysis was used to judge the correlation between the above indicators and BISAP score or APACHE ]] score. Results Among these cases, the detection rates of SAP by BISAP, APACHE II, Ranson and CTSI scoring systems were 54. 8%, 59. 5%, 54. 8% and 50. 0%, respectively. The detection rate of SAP by BISAP had no differences with other scoring systems. The serum levels of TG, FIB, CRP in SAP group were significantly higher than those in MAP group. The FIB, CRP levels were correlated with BISAP score and APACHE ]I score. Conclusion BISAP scoring system can be widely used in the diagnosis of severe acute hyperlipidemic pancreatitis. FIB, CRP detection has a certain value in evaluation and prediction of severity in hyperlipidemic pancreatitis in the early period.

关 键 词：急性胰腺炎(AP) 高脂血症 严重程度 BISAP评分系统 APACHEII评分系统 

分 类 号：R589.2[医药卫生—内分泌]