BISAP、Ranson和APACHEⅡ评分系统对高脂血症性急性胰腺炎患者病情和预后的评估价值

目的:研究急性胰腺炎床旁指数(BISAP)、Ranson和急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分系统对高脂血症性急性胰腺炎(HLAP)患者病情和预后的评估价值。方法:对2015年3月~2019年3月期间我院收治的160例HLAP患者的临床资料进行回顾性分析,其中轻度患者113例、中度患者26例、重度患者21例、并发症患者14例、死亡患者5例。采用Pearson相关检验三种评分与病情的相关性,分析三种评分与中/重度患者、并发症患者、死亡患者的关系,并通过受试者工作特征(ROC)曲线分析三种评分评估HLAP患者病情及预后的价值。结果:BISAP、Ranson、APACHEⅡ三种评分均随病情的加重呈上升趋势,有显著的正相关关系(P<0.05)。三种评分对HLAP患者病情严重程度具有较高的评估价值,曲线下面积(AUC)均在0.76以上,敏感度和特异度均高于0.7。BISAP评分≥3分、Ranson评分≥3分、APACHEⅡ评分≥8分的中/重度患者、并发症患者及死亡人数占比均分别高于BISAP评分<3分、Ranson评分<3分、APACHEⅡ评分<8分的患者(P<0.05)。三种评分对排除并发症和死亡的预测有较高价值,其特异度均在0.9以上。结论:BISAP、Ranson和APACHEⅡ评分系统应用于HLAP患者的病情和预后评估中均存在一定价值,值得临床推广应用。

Value of BISAP, Ranson and APACHEE II Scoring System in Evaluating the Condition and Prognosis of Patients with Hyperlipidemic Acute Pancreatitis

ABSTRACT Objective: To study the value of bedside index of acute pancreatitis (BISAP), Ranson and acute physiology and chronic health evaluation (APACHE II) scoring system in evaluating the condition and prognosis of patients with hyperlipidemic acute pancreatitis (HLAP). Methods: The clinical data of 160 patients with HLAP admitted to our hospital from March 2015 to March 2019 were retrospectively analyzed. Among them, 113 cases were light, 26 cases were moderate, 21 cases were severe, 14 cases were complications and 5 cases were dead. Pearson correlation test was used to examine the correlation between the three scoring systems and condition. The relationship between the three scoring systems and patients with moderate to severe, complications and deaths were analyzed. Value of three scoring systems in evaluating the condition and prognosis of HLAP patients by receiver operating characteristic (ROC) curve analysis. Results: The scores of BISAP, Ranson, APACHE II increased with the aggravation of the disease, and there were significant positive correlation between them (P<0.05). The three scoring systems had high value in evaluating the severity of HLAP, the area under curve (AUC) were above 0.76, and the sensitivity and specificity were higher than 0.7. The proportion of moderate to severe patients, complications patients, deaths with BISAP more than 3 scores, Ranson more than 3 scores, APACHE II more than 8 scores were higher than those with BISAP less than 3 scores, Ranson less than 3 scores, APACHE II less than 8 scores (P<0.05). The three scoring systems had high value in excluding complications and predicting death, and their specificity were above 0.9. Conclusion: The application of BISAP, Ranson, APACHE II scoring system in evaluating the condition and prognosis of HLAP patients has certain value, which is worthy of clinical application.