DAO、D-LA及APACHEⅡ、GCSI-R评分对急性胰腺炎患者病情严重程度及预后的评估价值  

Value of DAO,D-LA,APACHEⅡand GCSI-R Scores in Evaluating the Severity and Prognosis of Acute Pancreatitis

作　　者：范波 闫润生 FAN Bo;YAN Run-sheng(Emergency Medicine Department,Xianyang First People's Hospital,Xianyang Shaanxi 712000)

机构地区：[1]咸阳市第一人民医院急诊医学科,陕西咸阳712000 [2]中国人民解放军联勤保障部队第九八七医院急诊科,陕西宝鸡721004

出　　处：《医学临床研究》2022年第10期1452-1455,共4页Journal of Clinical Research

基　　金：陕西省重点研发计划项目(NO:2017ZDXM-SF-25-5)。

摘　　要：【目的】探讨二胺氧化酶(DAO)、D-乳酸(D-LA)及急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分、修订版胃瘫主要症状指数(GCSI-R)评分评估急性胰腺炎(AP)患者病情严重程度及预后的价值。【方法】选取100例AP患者的临床资料,根据病情严重程度分为轻症组(n=59)、中症组(n=29)、重症组(n=12),根据入院后28 d内是否死亡分为存活组(n=92)与死亡组(n=8)。比较不同病情严重程度及不同预后AP患者血清DAO、D-LA及APACHEⅡ评分、GCSI-R评分,通过Spearman相关系数分析血清DAO、D-LA及APACHEⅡ评分、GCSI-R评分与AP患者病情严重程度的相关性,采用受试者工作特征曲线(ROC曲线)分析上述指标评估AP患者预后的价值。【结果】三组血清DAO、D-LA及APACHEⅡ评分、GCSI-R评分比较,轻症组<中症组<重症组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,AP患者病情严重程度与血清DAO、D-LA及APACHEⅡ评分、GCSI-R评分呈正相关(P<0.05);存活组患者血清DAO、D-LA及APACHEⅡ评分、GCSI-R评分均显著低于死亡组,差异有统计学意义(P<0.05);经ROC曲线分析,DAO≥42.315 mg/L、D-LA≥40.690 U/L、APACHEⅡ评分≥26.000分、GCSI-R评分≥12.585分是评估AP患者预后的最佳截断值(P<0.05)。【结论】DAO、D-LA及APACHEⅡ、GCSI-R评分可用于反映AP患者病情严重程度及预后,且与AP病情严重程度呈正相关。【Objective】To study the value of diamine oxidase(DAO),D-lactic acid(D-LA),acute physiology and chronic healthⅡ(APACHEⅡ)score,and revised major symptom index of gastroparesis(GCSI-R)score in evaluating the severity and prognosis of acute pancreatitis(AP).【Methods】A total of 100 patients with AP were divided into mild(n=59),moderate(n=29)and severe(n=12)groups according to the severity of the disease.They were divided into survival(n=92)and death(n=8)groups according to whether they died within 28 days after admission.The serum DAO,D-LA,APACHEⅡscore and GCSI-R score of AP patients with different severity and prognosis were compared;Spearman correlation coefficient was used to analyze the relationship between serum DAO,D-LA,APACHEⅡscore,GCSI-R score and severity of AP patients;The prognostic value of AP patients was evaluated by ROC analysis of serum DAO,D-LA,APACHEⅡscore and GCSI-R score.【Results】Compared with serum DAO,D-LA,APACHEⅡscore and GCSI-R score,the difference was statistically significant between mild group and moderate group and severe group(P<0.05);By correlation analysis,the severity of AP patients was positively correlated with serum DAO,D-LA,APACHEⅡscore and GCSI-R score(P<0.05);The serum DAO,D-LA,APACHEⅡscore and GCSI-R score in the survival group were significantly lower than those in the death group(P<0.05);ROC analysis showed that DAO≥42.315 mg/L,D-LA≥40.690 U/L,APACHEⅡscore≥26.000,GCSI-R score≥12.585 were the best cut-off values for evaluating the prognosis of AP patients,all of which were P<0.05.【Conclusion】DAO,D-LA,APACHEⅡand GCSI-R scores can be used to reflect the severity and prognosis of AP patients,and are positively correlated with the severity of AP.

关 键 词：胰腺炎 急性病 胺氧化酶(含铜) 乳酸 急性病生理学和长期健康评价 预后 病人病情 

分 类 号：R576.1[医药卫生—消化系统]