营养风险评分对重症急性胰腺炎患者预后的预测价值  

The predictive value of nutritional risk score for prognosis in patients with severe acute pancreatitis

作　　者：徐燕 王爱娟 程红梅 孔令敏 XU Yan;WANG Aijuan;CHENG Hongmei;KONG Lingmin(Department of Gastroenterology,Affiliated Hospital of Yangzhou University,Yangzhou Jiangsu 225000,China)

机构地区：[1]扬州大学附属医院消化内科,江苏扬州225000 [2]扬州大学护理学院·公共卫生学院,江苏扬州225000

出　　处：《中国急救复苏与灾害医学杂志》2025年第4期456-459,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2020年省重点研发计划专项资金项目(BE2020717)。

摘　　要：目的 分析营养风险筛查2002(NRS-2002)、危重症营养风险(NUTRIC)评分对重症急性胰腺炎(SAP)患者预后的临床价值。方法 回顾性分析2021年4月—2023年5月扬州大学附属医院收治的140例SAP患者的临床资料,根据28 d死亡情况分为死亡组和存活组。比较两组患者的临床资料、NRS-2002评分和NUTRIC评分,并分析两项评分与患者28 d病死率的相关性。采用受试者操作特征(ROC)曲线分析NRS-2002和NUTRIC对SAP患者28 d死亡的预测价值。结果 140例SAP患者28 d死亡37例,病死率为26.43%。死亡组患者入院时的休克比例、受累器官数目、机械通气比例、序贯器官衰竭评分(SOFA)、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分、NRS-2002评分和NUTRIC评分均高于存活组(均P<0.05)。死亡组的白蛋白(ALB)水平低于存活组(t=5.849,P<0.05)。COX回归分析结果显示,NRS-2002评分(HR=2.566,95%CI:1.827~3.603)和NUTRIC评分(HR=1.680,95%CI:1.169~2.416)均为SAP患者28 d死亡的独立危险因素(均P<0.05)。NRS-2002、NUTRIC评分预测SAP患者28 d死亡的曲线下面积(AUC)分别为0.851(95%CI:0.781~0.906)、0.772(95%CI:0.693~0.838),最佳预测值均为6分,灵敏度和特异度分别为67.57%和89.32%、72.97%和69.90%。结论 NRS-2002评分和NUTRIC评分对SAP患者28 d预后有良好的预测价值,考虑操作便捷性,NRS-2002评分更优。Objective To analyze the predictive value of Nutritional risk screening 2002 (NRS-2002) and Nutrition risk in critically ill (NUTRIC) score for the prognosis of patients with severe acute pancreatitis (SAP).MethodsA retrospective analysis was conducted on the clinical data of 140 patients with SAP admitted to Yangzhou University Affiliated Hospital from April 2021 to May 2023.These patients were categorized into the death group and the survival group based on their mortality within 28 days.The clinical data,NRS-2002 score,and NUTRIC score were compared,and the correlation between these scores and the 28 d mortality rate was analyzed.The values of NRS-2002 and NUTRIC for predicting 28 days mortality of SAP patients were analyzed by receiver operating characteristic (ROC) curves.Results The 140 SAP patients died 37 at 28 days,with a mortality rate of 26.43%.In the death group,the proportion of shock,number of organs involved,proportion of mechanical ventilation,sequential organ failure assessment (SOFA),acute physiology and chronic health evaluationⅡ(APACHEⅡ) score,NRS-2002 score and NUTRIC score were all higher than those in the survival group(allP<0.05).Albumin (ALB) levels were lower in the dead group than in the surviving group(t=5.849,P<0.05).The results of the COX regression analysis showed that,the NRS-2002 score(HR=2.566,95%CI:1.827-3.603),and NUTRIC score (HR=1.680,95%CI:1.169-2.416)all were independent risk factors for 28 days death in SAP patients(allP<0.05).The area under the curve (AUC) of NRS-2002 and NUTRIC score predicting death in28 days of SAP patients was 0.851(95%CI:0.781-0.906) and 0.772(95%CI:0.693-0.838),respectively,the best predictive value was all set at 6 points,the sensitivity and specificity were 67.57%and 89.32%,72.97%,and 69.90%,respectively.ConclusionThe NRS-2002 score and NUTRIC score have good predictive value for the 28 days prognosis of SAP patients.Considering the convenience of operation,the NRS-2002 score is better.

关 键 词：重症急性胰腺炎 营养风险筛查2002 危重症营养风险评分 预后 预测 

分 类 号：R576[医药卫生—消化系统]