清下化瘀方对急性胰腺炎传统评分系统影响及预后评估Logistic回归分析  

Effect of Qingxia Huayu decotion on traditional scoring system of acute pancreatitis and Logistic regression analysis on prognosis evaluation

作　　者：孔婧[1] 王晓素[1] 熊光苏 周秉舵[1] 李英[1] 程传奇 何聪 秦艺文 KONG Jing;WANG Xiao-su;XIONG Guang-su;ZHOU Bing-duo;LI Ying;CHENG Chuan-qi;HE Cong;QIN Yi-wen(Department of Gastroenterology,Yueyang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院消化科,上海200437

出　　处：《中国中西医结合消化杂志》2020年第8期580-584,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：国家自然科学基金委员会面上项目(No:81973809);上海市申康医院发展中心中西医临床协作试点建设项目(No:ZY2018-2020-FWTX-1004)。

摘　　要：[目的]评价清下化瘀方干预对急性胰腺炎(AP)患者各传统评分系统的影响及预后评估。[方法]将60例中重症急性胰腺炎(MSAP)和重症急性胰腺炎(SAP)患者分为治疗组30例,对照组30例,对照组给予西药常规治疗,治疗组在对照组的基础上加服清下化瘀方,2组均治疗7 d后,观察临床疗效。对所有入选的AP患者进行传统常用评分系统BISAP评分、APACHEⅡ评分、MCTSI评分,比较其对AP患者发生MODS的评估功能。[结果]①治疗1周后,治疗组与对照组的BISAP评分、APACHEⅡ评分、MCTSI评分比较差异有统计学意义(P<0.01),治疗组评分低于对照组。②经ROC曲线分析,MCTSI评分、APACHEⅡ、BISAP评分系统对多器官功能衰竭(MODS)的预测能力相当,AUC均>0.5。③根据ROC分析结果,经Logistic回归分析显示,BISAP评分≥1.5、APACHEⅡ评分≥5.5是AP患者入院14 d内发生MODS的预测指标(P<0.05)。[结论]临床西医常规治疗结合早期清下化瘀方鼻饲可降低MODS发生率。MCTSI评分、APACHEⅡ、BISAP评分对AP预后的评估都有价值。在预测AP患者MODS发生率上,传统评分系统BISAP评分优于APACHEⅡ评分优于MCTSI评分系统。[Objective]To evaluate the effect of Qingxia Huayu decotion on traditional scoring system and prognosis of patients with acute pancreatitis(AP).[Methods]60 cases of severe acute pancreatitis(MSAP)and severe acute pancreatitis(SAP)were selected,which were divided into treatment group(30 cases)and control group(30 cases).The control group was given conventional western medicine treatment,and the treatment group was given Qingxia Huayu decotion on the basis of the control group.After 7 days of treatment,BISAP score,APACHE Ⅱ score and MCTSI score were given to observe the clinical efficacy.All the AP patients were evaluated by BISAP,APACHE Ⅱ and MCTSI to compare the assessment function for MODS.[Results]① After one week of treatment,there were significant differences in BISAP score,APACHE Ⅱ score and MCTSI score between the treatment group and the control group(P<0.01),and the score of the treatment group was lower than that of the control group.② According to ROC curve analysis,MCTSI score,APACHE Ⅱ score and BISAP score system had the same ability to predict MODS,for AUC>0.5.③ According to the results of ROC analysis,Logistic regression analysis showed that BISAP score ≥ 1.5,APACHE Ⅱ score ≥ 5.5 were the predictors of MODS in AP patients within 14 days after admission(P<0.05).[Conclusion]Conventional western medicine treatment combined with early Qingxia Huayu Decoction can reduce the incidence of MODS.MCTSI score,APACHE Ⅱ score and BISAP score are all valuable in evaluating the prognosis of AP.In predicting the incidence of MODS in AP patients,BISAP score is better than APACHE Ⅱ score,which are better than MCTSI score system.

关 键 词：重症急性胰腺炎 传统评分系统 预后评估 LOGISTIC回归分析 

分 类 号：R576[医药卫生—消化系统]