白蛋白-胆红素评分联合血尿素氮对重症急性胰腺炎的预测价值分析  

Predictive value of ALBI combined with in severe acute pancreatitis

作　　者：李雪琦 梁楠 关岚 田兆兴 Li Xueqi;Liang Nan;Guan Lan;Tian Zhaoxing(Department of Emergency Medicine,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035 China)

机构地区：[1]首都医科大学附属北京积水潭医院急诊科,北京100035

出　　处：《中华急诊医学杂志》2023年第10期1340-1345,共6页Chinese Journal of Emergency Medicine

摘　　要：目的通过分析急性胰腺炎(acute pancreatitis,AP)患者入院24 h内的相关血清学指标对重症急性胰腺炎(severe acute pancreatitis,SAP)的预测价值,为急诊科医生接诊时及时判断和预测AP严重程度提供参考。方法回顾性收集2022年1月至2022年12月于首都医科大学附属北京积水潭医院急诊入院的AP患者119例,根据修订版Atlanta分级(revised Atlanta classification,RAC),将患者分为轻症急性胰腺炎(mild acute pancreatitis,MAP)组(77例),中重症急性胰腺炎(moderately severe acute pancreatitis,MSAP)组(27例)和SAP组(15例),比较三组患者的基本特征、早期疾病严重程度评分和早期血清学指标,分析影响SAP发生的血清学指标独立危险因素,绘制受试者工作特征曲线(receiver operator characteristic,ROC),评价相关血清学指标对SAP的预测价值。结果三组患者的基本特征在性别、年龄、BMI、胰腺炎类型、合并症方面差异无统计学意义(P>0.05),三组患者的早期BISAP、Ranson、APACHEⅡ、Panc3评分差异具有统计学意义(P<0.05);血清学指标白蛋白-胆红素评分(albumin-bilirubin,ALBI)(OR=3.653,95%CI 1.665~8.012,P=0.001)、血尿素氮(blood urea nitrogen,BUN)(OR=1.117,95%CI 1.039~1.202,P=0.003)是SAP发生的独立危险因素;ALBI、BUN、ALBI联合BUN预测SAP的ROC曲线下面积分别为0.762、0.776、0.857,分别与Ranson、BISAP、APACHEⅡ评分系统相比差异无统计学意义(P>0.05)。结论AP患者早期ALBI、BUN指标对SAP具有良好预测价值,ALBI联合BUN可提高对SAP的预测价值,预测效果与Ranson、BISAP、APACHEⅡ评分系统差异无统计学意义。Objective To analyze the predictive value of serological measures within 24 hours of admission in acute pancreatitis patients against patients with severe acute pancreatitis(SAP),because the severity of acute pancreatitis was characterized by a timely assessment and prediction by emergency department physicians upon visit.MethodsA total of 119 acute pancreatitis patients admitted in Emergency Department in Beijing Jishuitan Hospital,Capital Medical University from January 2022 to December 2022 were retrospectively collected.According to the revised Atlanta classification,patients were characterized by mild acute pancreatitis group(77 cases),moderately severe acute pancreatitis group(27 cases),and SAP group(15 cases).Basic characteristics,early disease severity scores and early serological indexes of the three groups were compared,independent risk factors of serological indexes affecting the occurrence of SAP were analyzed,and receiver operator characteristic curve was drawn,evaluate the predictive value of related serological indexes for SAP.Results There were no significant differences in the basic characteristics of the three groups including of gender,age,BMI,type of pancreatitis and complications(P>0.05),but there were significant differences in early BISPA,Ranson,APACHE Ⅱ and Panc3 scores among the three groups(P<0.05).Albumin-bilirubin score(OR=3.653,95%CI 1.665-8.012,P=0.001),blood urea nitrogen(OR=1.117,95%CI 1.039-1.202,P=0.003)were independent risk factors for SAP.The areas under ROC curve predicted by albumin-bilirubin score,blood urea nitrogen and albumin-bilirubin score combined with blood urea nitrogen were 0.762,0.776 and 0.857,respectively,which showed no statistical difference compared with earlier Ranson,BISAP and APACHE Ⅱ scoring systems,respectively(P>0.05).Conclusions Early albumin-bilirubin score and blood urea nitrogen indexes of acute pancreatitis patients have good predictive value for SAP.Albumin-bilirubin score combined with blood urea nitrogen can improve the predictive value of SA

关 键 词：重症急性胰腺炎 疾病严重程度 白蛋白-胆红素 血尿素氮 血清学指标 急性胰腺炎预测评分系统 RANSON评分 APACHEⅡ评分 

分 类 号：R576[医药卫生—消化系统]