BISAPG评分对急性胰腺炎严重程度的预测价值  

The value of BISAPG score in predicting the severity of acute pancreatitis

作　　者：张圣杰 袁磊[1] 季梦遥[1] ZHANG Sheng-jie;YUAN Lei;JI Meng-yao(Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院消化科,430060

出　　处：《现代消化及介入诊疗》2023年第6期704-708,713,共6页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：国家自然基金(81901817)。

摘　　要：目的探讨急性胰腺炎严重程度床边指数(BISAP)评分联合空腹血糖(fasting blood glucose,FBG)水平(BISAPG)对急性胰腺炎(AP)严重程度的预测价值。方法回顾性分析2020年8月至2022年8月在武汉大学人民医院确诊为AP的患者264例,其中诊断为重症急性胰腺炎(SAP)的患者96例,非重症急性胰腺炎(NSAP)168例。收集患者临床相关数据、实验室数据、BISAP评分和入院24小时内FBG。采用多因素Logistic回归模型分析SAP发生的危险因素。用Spearman相关分析法分析BISAP评分和FBG之间的关系。采用受试者工作特征曲线(ROC)评估BISAP评分、FBG及BISAPG评分对AP严重程度的预测价值。用校准曲线以及决策曲线分析分别评估BISAPG评分拟合度和临床实用性。结果SAP组Alb、A/G、RBC值均小于NSAP组,FBG、WBC、AMY、LIPA、PCT、CRP及BISAP评分均大于NSAP组(P<0.05),两组在TG、BMI指数、性别间无统计学差异(P>0.05)。多因素分析显示,BISAP评分及入院24小时内FBG是SAP发生的独立危险因子(P<0.05)。Spearman相关分析显示,FBG值与BISAP评分呈正相关关系(r=0.409,P<0.01)。BISAP评分、FBG预测SAP的曲线下面积(AUC)分别为0.832、0.810。BISAPG预测SAP发生的AUC为0.882,高于二者的独立评价,并且具有较高的临床实用性。结论BISAP评分和FBG对急性胰腺炎严重程度均具有一定预测价值,二者联合应用时预测价值更高。Objective To evaluate the value of bedside index of severity in acute pancreatitis(BISAP)score combined with fasting blood glucose(FBG)(BISAPG)in predicting the severity of acute pancreatitis(AP).Methods A retrospective analysis was conducted on 264 patients diagnosed with AP in Renmin Hospital of Wuhan University from August 2020 to August 2022,including 96 cases diagnosed with severe acute pancreatitis(SAP)and 168 cases diagnosed with non-severe acute pancreatitis(NSAP).The demographic data,laboratory data,BISAP score and FBG within 24 hours after admission were collected.Multivariate Logistic regression model was used to analyze the risk factors of SAP.Spearman correlation analysis was used to analyze the relationship between BISAP score and FBG.The predictive value of BISAP score,FBG and BISAPG score to AP severity was evaluated by receiver operating characteristic curve(ROC).Calibration curve and decision curve analysis were used to evaluate the BISAPG score's accuracy and clinical practicability.Results The values of Alb,A/G and RBC in SAP group were lower than those in NSAP group,the FBG,WBC,AMY,LIPA,PCT,CRP and BISAP score were all higher than those in NSAP group(P<0.05).There were no significant differences in TG,BMI and gender between the two groups(P>0.05).Multivariate analysis showed that BISAP score and FBG within 24 hours of admission were independent risk factors for SAP(P<0.05).Spearman correlation analysis showed that FBG was positively correlated with BISAP score(r=0.409,P<0.01).The area under the curve(AUC)of BISAP score and FBG prediction of SAP were 0.832 and 0.810.BISAPG score predicted the occurrence of SAP with an AUC of 0.882,which was higher than of the two alone and had higher clinical practicability.Conclusion Both BISAP score and FBG have a certain predictive value for the severity of acute pancreatitis,and the predictive value is higher when they are combined.

关 键 词：空腹血糖 急性胰腺炎严重程度床边指数 急性胰腺炎 

分 类 号：R576[医药卫生—消化系统]