Balthazar CT分级及CECT坏死体积衰减值与急性坏死性胰腺炎患者预后的相关性研究  

Correlation of Balthazar CT Grading and CECT Necrotic Volume and Attenuation Values with Prognosis of Patients with Acute Necrotizing Pancreatitis

作　　者：高明生[1] 奉镭[1] 姚勇[1] GAO Mingsheng;FENG Lei;YAO Yong(Suining Central Hospital,Sichuan Suining 629000,China)

机构地区：[1]四川省遂宁市中心医院消化内科,四川遂宁629000

出　　处：《河北医学》2022年第12期2067-2072,共6页Hebei Medicine

基　　金：四川省卫生健康委员会科研课题(普及应用项目),(编号:20PG286)。

摘　　要：目的:分析Balthazar CT分级及增强CT(CECT)坏死体积、衰减值与急性坏死性胰腺炎患者预后的相关性。方法:选取2019年6月至2021年6月我院收治的92例急性坏死性胰腺炎患者,根据随访6个月的临床预后分为预后不良组和预后良好组,收集两组患者一般资料,比较两组Balthazar CT、CECT坏死体积、衰减值,多因素logistic回归分析急性坏死性胰腺炎患者预后的影响因素,受试者工作特征曲线(ROC)分析Balthazar CT分级、CECT坏死体积、衰减值对急性坏死性胰腺炎患者预后的预测价值。结果:随访6个月,92例急性坏死性胰腺炎患者预后不良64例,预后良好28例。两组年龄、性别、体质量指数、发病时间、病因、合并症、淀粉酶(AMS)、白蛋白(ALB)比较差异无统计学意义(P>0.05),预后不良组APACHEⅡ评分、C反应蛋白(CRP)、尿素氮、Balthazar CT、坏死体积、平均衰减值明显高于预后良好组(P<0.05);logistics分析显示,Balthazar CT分级、坏死体积、平均衰减值是急性坏死性胰腺炎患者预后不良的独立危险因素(P<0.05);Balthazar CT分级、坏死体积、平均衰减值预测急性坏死性胰腺炎患者预后的曲线下面积(AUC)分别为0.765、0.624、0.764、0.861。结论:急性坏死性胰腺炎预后不良患者Balthazar CT分级、坏死体积、平均衰减值均明显较高,其也是预后不良的独立危险因素,能够协助临床预测急性坏死性胰腺炎患者预后,联合检测应用效果更好。Objective:To analyze the correlation between Balthazar CT grading and contrast-enhanced CT(CECT)necrosis volume and attenuation value and prognosis of patients with acute necrotizing pancreatitis.Methods:92 patients with acute necrotizing pancreatitis who were treated in the hospital were selected between June 2019 and June 2021,and they were divided into the poor prognosis group and the good prognosis group according to the clinical prognosis at 6 months of follow-up.The general data of the two groups of patients were collected,and Balthazar CT,CECT necrosis volume and attenuation value were compared between the two groups.Multivariate logistic regression analysis was used to analyze the influencing factors of prognosis in patients with acute necrotizing pancreatitis.Receiver operating characteristic curve(ROC)was adopted to analyze the predictive value of Balthazar CT grading,CECT necrosis volume and attenuation value on prognosis in patients with acute necrotizing pancreatitis.Results:At 6 months of follow-up,there were 64 cases of poor prognosis and 28 cases of good prognosis among 92 patients with acute necrotizing pancreatitis.There were no significant differences in age,gender,body mass index,onset time,etiology,comorbidities,amylase(AMS)and albumin(ALB)between the two groups(P>0.05).The APACHEⅡscore,C-reactive protein(CRP),blood urea nitrogen,Balthazar CT,necrosis volume and average attenuation value in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05).Logistics analysis showed that Balthazar CT grading,necrosis volume and average attenuation value were independent risk factors for poor prognosis in patients with acute necrotizing pancreatitis(P<0.05).The areas under the curves(AUCs)of Balthazar CT grading,necrosis volume and average attenuation value on predicting the prognosis of patients with acute necrotizing pancreatitis were 0.765,0.624,0.764 and 0.861 respectively.Conclusion:The Balthazar CT grading,necrosis volume and average attenuation value are

关 键 词：急性坏死性胰腺炎 Balthazar CT分级 增强CT 坏死体积 衰减值 预后 

分 类 号：R576[医药卫生—消化系统]