BISAP和APACHE Ⅱ评分对急性胰腺炎患者病情严重程度预测价值的差异性比较  

Comparative analysis of BISAP and APACHE Ⅱ scoring systems in early prediction of severity of acute pancreatitis

作　　者：冉军[1] 王大巍[2] 

机构地区：[1]辽宁医学院附属第三医院老年病科,辽宁省锦州市121000 [2]辽宁医学院附属第三医院普外一科,辽宁省锦州市121000

出　　处：《世界华人消化杂志》2014年第32期5005-5008,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨并比较不同评分系统对急性胰腺炎(acute pancreatitis,AP)患者病情严重程度预测价值的差异性.方法:回顾分析2011-06/2013-12在辽宁医学院附属第三医院住院并治疗的120例AP患者的临床资料,分别进行床旁急性胰腺炎严重度评分(bedside index for severity in acute pancreatitis,BISAP)及与急性生理学及慢性健康状况评分Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ),并绘制受试者工作曲线,比较两者对AP病情严重程度的预测价值.结果:BISAP评分及与APACHEⅡ评分的分值均随着病情的价值、局部并发症、器官衰竭及死亡率的增加而增加,差异具有统计学意义(P<0.05).BISAP评分及与APACHEⅡ评分在预测AP患者病情严重程度时,曲线下面积分别为0.821,0.903,前者的敏感度为74.5%,特异度为71.3%,阳性预测值为57.1%,阴性预测值为84.6%,均显著低于APACHEⅡ评分的对应值(分别为87.5%、83.0%、70.8%、90.2%),且差异有统计学意义(P<0.05).结论:BISAP评分及与APACHEⅡ评分均能对A P患者病情的严重程度进行预测,但前者操作更简单,易于临床推广.AIM： To compare the value of bedside index for severity in acute pancreatitis （BISAP） and acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ） scoring systems in early predic- tion of severity of acute pancreatitis （AP）. METHODS： Clinical data for 120 patients with AP treated from June 2012 to December 2013 were retrospectively analyzed. The receiver operating characteristic curve and the area under the curve （AUC） were used to compare the ability of BISAP and APACHE Ⅱ to predict the severity and prog- nosis of AP. RESULTS： The severity, complications, or-gan failure and death of AP patients became significantly wore as the scores of BISAP and APACHE Ⅱ increased （P 〈 0.05）. The AUCs of BISAP and APACHE Ⅱ scores in the prediction of AP severity were 0.821 and 0.903, respective- ly; The sensitivity, specificity, positive predictive value and negative predictive value of BISAP were significantly lower than those of APACHE Ⅱ score （74.5% vs 87.5%, 71.3% vs 87.5%, 57.1% vs 87.5%, 84.6% vs 83.0%, P 〈 0.05）. CONCLUSION： Both BISAP and APACHE Ⅱ scoring systems can predict the severity of AP, with BISAP being more simple and easier.

关 键 词：急性胰腺炎 BISAP评分 APACHEⅡ评分 严重程度 

分 类 号：R657.51[医药卫生—外科学]