基于CT评估腹部脂肪分布评估急性胰腺炎严重程度及其预后的价值  

Evaluation Value of Abdominal Fat Distribution Based on CT Assessment for the Severity and Prognosis of Acute Pancreatitis

作　　者：谢海伟[1] 苏万通 朱斌[1] XIE Hai-wei;SU Wan-tong;ZHU Bin(Department of General Surgery,Nanjing First Hospital,Nanjing Medical University,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院普外科,江苏南京210000

出　　处：《中国CT和MRI杂志》2024年第12期113-116,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨基于CT评估腹部脂肪分布评估急性胰腺炎严重程度及其预后的价值。方法选取2020年1月~2023年2月在我院就诊的80例重症急性胰腺炎患者的临床资料进行研究,将其设为SAP组。另选同期在我院就诊的42例轻症急性胰腺炎患者作为MAP组。比较SAP组与MAP组患者的临床资料、腹部脂肪分布参数[内脏脂肪组织(VAT)面积、皮下脂肪组织(SAT)面积、总脂(TAT)面积、VAT与TAT的比值、VAT与SAT的比值],绘制受试者工作特征(ROC)曲线分析基于CT评估腹部脂肪分布评估急性胰腺炎严重程度的价值。进一步根据患者预后将SAP组患者分为存活亚组(n=62)与死亡亚组(n=18)。分析基于CT评估腹部脂肪分布评估重症急性胰腺炎预后的价值。结果SAP组与MAP组患者性别、年龄、吸烟史、饮酒史、高血压史、糖尿病史、高脂血症史、胆管疾病史比较无显著差异(P>0.05);SAP组与MAP组患者BMI、CTSI评分、EPIC评分比较有显著差异(P<0.05)。SAP组与MAP组患者SAT面积比较无显著差异(P>0.05);SAP组患者VAT面积、TAT面积、VAT/TAT、VAT/SAT均大于MAP组患者(P<0.05);建立ROC曲线分析显示,VAT面积、TAT面积、VAT/TAT、VAT/SAT诊断急性胰腺炎严重程度的曲线下面积(AUC)值分别为0.838、0.755、0.701、0.853,均对急性胰腺炎严重程度有一定诊断价值;存活亚组与死亡亚组患者SAT面积、VAT/TAT、VAT/SAT比较无显著差异(P>0.05);死亡亚组患者VAT面积、TAT面积均大于存活亚组患者(P<0.05);VAT面积、TAT面积诊断重症急性胰腺炎患者预后的AUC值分别为0.758、0.673,均对急性胰腺炎严重程度有一定诊断价值。结论基于CT评估腹部脂肪分布用于评估急性胰腺炎严重程度及其预后有一定临床价值,可考虑作为辅助诊断急性胰腺炎严重程度和评估患者预后的参考指标。Objective To explore the evaluation value of abdominal fat distribution based on CT assessment for the severity and prognosis of acute pancreatitis.MethodsThe clinical data were collected from 80 patients with severe acute pancreatitis(SAP group)treated in the hospital between January 2020 and February 2023,and 42 patients with mild acute pancreatitis(MAP)during the same period were enrolled as MAP group.The clinical data and abdominal fat distribution parameters[visceral adipose tissue(VAT)area,subcutaneous adipose tissue(SAT)area,total fat(TAT)area,VAT/TAT ratio,VAT/SAT ratio]were compared between SAP group and MAP group.The evaluation value of abdominal fat distribution based on CT assessment for the severity and acute pancreatitis was analyzed by receiver operating characteristic(ROC)curves.According to prognosis,SAP patients were further divided into survival(n=62)and death(n=18).The evaluation value of abdominal fat distribution based on CT assessment for the prognosis of acute pancreatitis was analyzed.ResultsThere was no significant difference in gender,age,smoking history,drinking history,hypertension history,history of diabetes mellitus,hyperlipidemia history or history of bile duct diseases between SAP group and MAP group(P>0.05),there were significant differences in bMI,CTSI and EPIC scores(P<0.05),and there was no significant difference in SAT area(P>0.05).VAT area,TAT area,VAT/TAT and VAT/SAT in SAP group were higher than those in MAP group(P<0.05).ROC curves analysis showed that area under the curve(AUC)values of VAT area,TAT area,VAT/TAT and VAT/SAT for evaluating the severity of acute pancreatitis were 0.838,0.755,0.701 and 0.853,all showing certain diagnostic value.There was no significant difference in SAT area,VAT/TAT or VAT/SAT between survival group and death group(P>0.05).VAT area and TAT area in death group were larger than those in survival group(P<0.05).AUC values of VAT area and TAT area for evaluating the prognosis of acute pancreatitis were 0.758 and 0.673,all showing certain diagnost

关 键 词：CT 腹部脂肪分布 急性胰腺炎 严重程度 预后价值 

分 类 号：R657.51[医药卫生—外科学]