【摘要】 目的探讨BISAP评分、胰腺炎结局预测(pancreatitis outcome prediction,POP)评分系统相对于APACHEⅡ评分、Ranson评分对重症急性胰腺炎(SAP)患者预后的评估价值。方法回顾性分析2002年1月～2012年1月在温州医学院附属第一医院住院的224例SAP患者,分别计算入院时BISAP评分、POP评分、APACHEⅡ评分、Ranson评分分值,用受试者工作曲线(ROC曲线)分析各临床评分系统在判断SAP预后上的准确性。结果 ROC曲线分析显示各评分预测SAP死亡的受试者工作曲线面积(AUC)大小依次为POP评分、BISAP评分、APACHEⅡ评分、Ranson评分,即0.890、0.861、0.798、0.788。相应的最佳诊断阈值分别为10、4、12、6。POP评分诊断阈值为10时,预测SAP死亡的准确性最佳(91.75%)。各评分预测MODS的AUC大小依次为BISAP评分、APACHEⅡ评分、Ranson评分、POP评分,即0.839、0.813、0.769、0.745。相应的最佳诊断阈值分别为3、14、6、7。BISAP评分诊断阈值为3时,预测准确性最佳(80.36%)。结论 BISAP评分、POP评分对SAP预后评估价值较APACHEⅡ评分、Ranson评分更具优势,BISAP评分预测SAP并发MODS方面价值最为突出,POP评分预测SAP死亡方面价值最为突出。更多还原

【Abstract】 Objective To assess the value of BISAP,POP,APACHEⅡ and Ranson scoring systems in predicting the prognosis of severe acute pancreatitis(SAP).Methods A total of 224 consecutive patients with SAP,who admitted into the first affiliated hospital of Wenzhou Medical college from January 2002 to January 2012,were studied retrospectivly.Date associated to BISAP,POP,APACHEⅡ and Ranson scoring systems on admission were recorded.The receiver operating characteristic curves(ROC)and the areas under the ROC curve(AUC) were used for comparison of diagnostic accuracy of these prediction scores.Results Based on ROC analysis,the AUC of POP,BISAP,APACHEⅡ and Ranson was 0.890,0.861,0.798,0.788 respectively in predicting the death of SAP.And the relative best cut-off values of these prediction scores were 10,4,12,6,respectively.With the cut-off value of 10,POP achieved the most highest diagnostic accuracy(91.75%).And in predicting the MODS,the AUC of BISAP,APACHEⅡ,Ranson and POP was 0.839,0.813,0.769,0.745,respectively.And the relative best cut-off values of these prediction scores were 3,14,6,7.With the cut-off value of 3,BISAP achieved the most highest diagnostic accuracy(80.36%).Conclusion The value of BISAP and POP scoring systems was superior to APACHE II and Ranson in predicting the prognosis of SAP.更多还原