血清脂肪酶联合Ranson或BISAP评分系统诊断急性胰腺炎严重程度的效果分析

陈东来; 廖振海; 林顺权

doi:10.3969/j.issn.1001-5256.2016.02.026

血清脂肪酶联合Ranson或BISAP评分系统诊断急性胰腺炎严重程度的效果分析

DOI: 10.3969/j.issn.1001-5256.2016.02.026

惠东县第二人民医院内科

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中图分类号: R576
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出版历程
- 收稿日期: 2015-07-20
- 出版日期: 2016-02-20

Diagnostic value of serum lipase combined with Ranson or BISAP scoring system in assessment of severity of acute pancreatitis

Department of Internal Medicine,The Second People' s Hospital of Huidong County

摘要

摘要: 目的探讨血清脂肪酶联合Ranson或BISAP评分系统在急性胰腺炎严重程度中的诊断意义。方法选取2012年2月-2015年2月惠东县第二人民医院收治的急性胰腺炎患者314例,分为轻症急性胰腺炎（MAP）组（n=202）和重症急性胰腺炎（SAP）组（n=112）。对所有患者分别进行血清脂肪酶检测、Ranson评分、BISAP评分、脂肪酶联合Ranson或BISAP评分。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验,不同评估方法间曲线下面积（AUC）、约登指数比较采用Z检验。结果 SAP患者的血清脂肪酶水平、Ranson评分值、BISAP评分值均显著高于MAP患者,差异均有统计学意义（t值分别为14.89、11.89、5.12,P值分别为0.003、0.007、0.037）。预测器官功能衰竭、胰腺坏死和病死率的AUC中,脂肪酶联合BISAP评分系统均高于BISAP评分,差异均有统计学意义（Z值分别为7.54、7.11、7.57,P值分别为0.033、0.031、0.030）;脂肪酶联合Ranson评分系统均高于Ranson评分,差异均有统计学意义（Z值分别为5.23、5.78、...
- 胰腺炎 /
- 脂肪酶 /
- Ranson评分 /
- BISAP评分 /
- 诊断
Abstract: Objective To investigate the diagnostic value of serum lipase combined with the Ranson or BISAP scoring system in the assessment of severity of acute pancreatitis. Methods A total of 314 patients with acute pancreatitis who were admitted to The Second People' s Hospital of Huidong County from February 2012 to February 2015 were selected and divided into mild acute acute pancreatitis( MAP) group( 202 patients) and severe acute pancreatitis( SAP) group( 112 patients). Serum lipase determination,Ranson scoring,BISAP scoring,serum lipase determination combined with Ranson scoring,and serum lipase determination combined with BISAP scoring were performed for all the patients. The t- test was applied for comparison of continuous data between groups,the chi- square test was applied for comparison of categorical data between groups,and the Z test was applied for the comparison of area under the receiver operating characteristic curve( AUC) and Youden index between different methods. Results The patients with SAP had significantly higher serum lipase level,Ranson score,and BISAP score than those with MAP( t = 14. 89,11. 89,and 5. 12,P = 0. 003,0. 007,and 0. 037). As for the AUCs for the prediction of organ failure,pancreatic necrosis,and death,serum lipase determination combined with the BISAP scoring system had significantly higher AUCs than the BISAP scoring system( Z = 7. 54,7. 11,and 7. 57,P = 0. 033,0. 031,and 0. 030),serum lipase determination combined with the Ranson scoring system had significantly higher AUCs than the Ranson scoring system( Z = 5. 23,5. 78,and 6. 18,P =0. 037,0. 034,and 0. 032),and serum lipase determination combined with the BISAP scoring system had significantly higher AUCs than serum lipase determination combined with the Ranson scoring system( Z = 13. 55,8. 33,and 7. 66,P = 0. 005,0. 029,and 0. 031). As for Youden index for the prediction of organ failure,pancreatic necrosis,and death,serum lipase determination combined with the Ranson scoring system had a significantly higher Youden index than the Ranson scoring system( Z = 5. 17,6. 89,and 7. 35,P = 0. 038,0. 032,and 0. 027),serum lipase determination combined with the BISAP scoring system had a significantly higher Youden index than the BISAP scoring system( Z = 7. 54,7. 22,and 9. 57,P = 0. 030,0. 031,and 0. 025),and serum lipase determination combined with the BISAP scoring system had a significantly higher Youden index than serum lipase determination combined with the Ranson scoring system( Z =10. 11,10. 23,and 13. 24,P = 0. 020,0. 019,and 0. 010). Conclusion Compared with the Ranson scoring system or BISAP scoring system alone,serum lipase determination combined with the Ranson or BISAP scoring system is more accurate in the assessment of severity of acute pancreatitis,and serum lipase determination combined with the BISAP scoring system has a higher sensitivity and a greater diagnostic value in clinical practice.
- pancreatitis /
- lipase /
- Ranson scoring system /
- BISAP scoring system /
- diagnosis

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参考文献(16)

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