预测重症急性胰腺炎预后模型的构建和验证  

Establish and Validation of Prognostic Model for Severe Acute Pancreatitis

作　　者：何宇敏 赵燊[1,2,3] 王晓萍 邵菲[4] 唐子人 HE Yu-min;ZHAO Shen;WANG Xiao-ping;SHAO Fei;TANG Zi-ren(Department of Emergency,Fujian Provincial Hospital,350001;Shengli Clinical Medical College of Fujian Medical University;Fujian Provincial Key Laboratory of Emergency Medicine;Department of Emergency,Beijing Chaoyang Hospital,Capital Medical University)

机构地区：[1]福建省立医院急诊科,350001 [2]福建医科大学省立临床医学院 [3]福建省急诊医学重点实验室 [4]首都医科大学附属北京朝阳医院急诊科

出　　处：《岭南急诊医学杂志》2021年第2期140-143,共4页Lingnan Journal of Emergency Medicine

基　　金：福建省自然科学基金(2020J05263)。

摘　　要：目的:通过列线图建立重症急性胰腺炎(Severe Acute Pancreatitis,SAP)患者生存结局的早期临床预测模型。方法:选择2015年1月至2019年12月福建省立医院及北京市朝阳医院收治的SAP患者为研究对象,运用Cox回归模型筛选影响预后的因素,根据危险因素的风险比构建列线图。评估预测模型的区分度和准确性。结果:纳入271例患者,建模队列160例。APACHEⅡ评分、SOFA评分、是SAP死亡独立危险因素;构建的预测模型在建模队列和校正队列中的C-指数分别为0.800、0.808,校正曲线均接近斜率为1的直线。结论:APACHE Ⅱ评分、SOFA评分、CT E级是SAP患者死亡的独立危险因素,由其构建的预测模型能较准确的预测SAP患者90天生存率,并具有较高的外部预测性。Objective:To establish a nomogram for predicting 90-day survival rate of patients with severe acute pancreatitis(SAP). Methods:This study included patients with SAP admitted to two tertiary hospital from January 2015 to December 2019. The risk factors were selected by Cox regression model. Nomogram was established according to the risk ratio of risk factors. And we verified the performance of the model. Results:There were 271 patients included and the prediction cohort enrolled 160 patients. APACHE Ⅱ score,SOFA score,CT grade E were independent risk factors affecting the survival rate of patients with SAP. The C-index of the prediction cohort and the validation cohort were 0.800 and 0.808 respectively. Both internally and externally verified calibration curves showed that the predicted results were close to the actual survival rates. Conclusion:APACHE Ⅱ score,SOFA score and CT grade E were independent risk factors affecting the survival rate of patients with SAP. Based on these factors,the prognosis prediction model we established with nomogram can help predict the 90-day survival rate of patients with SAP.

关 键 词：重症急性胰腺炎 APACHEⅡ评分 SOFA评分 CT分级 列线图 

分 类 号：R576[医药卫生—消化系统]