不同评分系统对基于新修订Atlanta标准的老年急性胰腺炎患者预后预测价值的比较  

Comparison of prognostic value of different scoring systems in elderly patients with acute pancreatitis based on the newly revised Atlanta criteria

作　　者：翁艳 金鳞 褚云香 王东胜 贾志伟 刘晓川 WENG Yan;JIN Lin;CHU Yun-xiang;WANG Dong-sheng;JIA Zhi-wei;LIU Xiao-chuan(Gastroenterology Department,Emergency Management Department Emergency General Hospital,Beijing 100028,China)

机构地区：[1]应急管理部应急总医院消化内科,北京100028

出　　处：《中国临床药理学杂志》2024年第16期2329-2333,共5页The Chinese Journal of Clinical Pharmacology

基　　金：应急总医院医学发展科研基金资助项目(K201915)。

摘　　要：目的比较在新修订Atlanta标准下,不同评分系统对老年患者急性胰腺炎(AP)严重程度、器官衰竭及并发症的早期预测价值。方法收集我院急性胰腺炎患者的病历资料。患者入院后,完成计算机断层扫描严重程度指数(CTSI)评分、急性胰腺炎严重程度床边指数(BISAP)评分、胰腺3项(PANC-3)评分、无害性急性胰腺炎(HAPS)评分。比较4种评分预测SAP、胰腺局部并发症及多器官功能衰竭的受试者工作特征(ROC)的曲线下面积(AUC)及敏感度、特异性、约登指数。结果CTSI、BISAP、PANC-3、HAPS评分系统预测SAP的AUC分别为0.76、0.91、0.48、0.55,敏感度分别为75.87%、89.61%、61.18%、78.38%,特异性分别为80.29%、74.72%、67.48%、69.69%,约登指数分别为0.56、0.64、0.29、0.48。CTSI、BISAP、PANC-3、HAPS评分系统预测胰腺局部并发症的AUC分别为0.94、0.82、0.59、0.64,敏感度分别为74.59%、68.23%、71.11%、69.28%,特异性分别为93.88%、83.01%、78.59%、76.46%,约登指数分别为0.68、0.51、0.50、0.46。CTSI、BISAP、PANC-3、HAPS评分系统预测多器官衰竭的AUC分别为0.60、0.84、0.64、0.80,敏感度分别为54.18%、74.82%、58.59%、65.67%,特异性分别为76.11%、77.20%、72.68%、89.36%,约登指数分别为0.30、0.52、0.31、0.55。结论BISAP评分在预测SAP的准确度、多器官衰竭风险方面均高于CTSI、HAPS、PANC-3评分系统。Objective To compare the early predictive value of different scoring systems for the severity,organ failure and complications of acute pancreatitis(AP)in elderly patients under the newly revised Atlanta criteria.Methods Patients with acute pancreatitis treated was collected.After admission,complete the computed tomography severity index(CTSI),the bedside index of severity in acute pancreatitis(BISAP),the pancreatis 3(PANC-3)and the harmlessness acute pancreatitis score(HAPS).The area under receiver operating characteristic(ROC)curve(AUC),sensitivity,specificity and Yordan's index of four scores for predicting SAP,local pancreatic complications and multiple organ failure were compared.Results The areas under the ROC curve predicted by the CTSI,BISAP,PANC-3 and HAPS scoring systems for SAP were 0.76,0.91,0.48 and 0.55;sensitivities of 75.87%,89.61%,61.18%and 78.38%;specificity of 80.29%74.72%,67.48%and 69.69%;Yordan's index of 0.56,0.64,0.29 and 0.48,respectively.The AUC of CTSI,BISAP,PANC-3 and HAPS scoring systems for predicting local pancreatic complications were 0.94,0.82,0.59 and0.64;sensitivity of 74.59%,68.23%,71.11%and 69.28%;specificity of 93.88%,83.01%,78.59%and76.46%;Yordan's index were 0.68,0.51,0.50 and 0.46,respectively.The AUC of CTSI,BISAP,PANC-3 and HAPS scoring systems for predicting multiple organ failure were 0.60,0.84,0.64 and 0.80,sensitivities were54.18%,74.82%,58.59%and 65.67%,specificity were 76.11%,77.20%,72.68%and 89.36%,Jordan's indices were 0.30,0.52,0.31 and 0.55,respectively.Conclusion BISAP score is higher than CTSI,HAPS and PANC-3 scoring system in predicting the accuracy of sap and the risk of multiple organ failure.

关 键 词：Atlanta标准 急性胰腺炎 老年 预后 预测 

分 类 号：R97[医药卫生—药品]