多种CT评分对早期重症急性胰腺炎患者假性囊肿形成的预测价值比较

The Value of Different Scoring Systems for Computed Tomography in Predicting Pancreatic Pseudocyst in Severe Acute Pancreatitis

目的探讨多种CT评分对早期重症急性胰腺炎(severe acute pancreatitis,SAP)患者假性囊肿(pancreatic pseudocyst,PPC)形成的预测价值。方法回顾性分析我院2007年10月至2009年12月收治的SAP患者162例的临床资料和CT表现,并进行相关CT评分,包括CT严重指数(CTSI)、改良CT严重指数(MCTSI)和CT胰外炎症评分(EPIC)。运用ROC曲线比较分析各项CT评分对PPC形成的预测价值。结果所有SAP患者中共观察到48例形成PPC(29.6%),PPC组的CTSI、MCTSI、EPIC和腹水发生率均高于未形成PPC组。在各项CT评分中,EPIC评分预测PPC形成的准确性较好〔ROC曲线下面积(AUC)为0.914〕,优于CTSI评分(AUC为0.674)和MCTSI(AUC为0.72)。结论各项CT评分中,EPIC评分预测SAP患者PPC形成的准确性优于传统的CTSI和MCTSI。

Objective To evaluate the value of several Computed Tomograph （CT） scoring systems in predicting the development of acute pancreatic pseudocyst （PPC） in severe acute pancreatitis （SAP） during early stage. Methods One hundred and sixty-two patients with SAP were retrospectively observed and subjected to clinical, laboratory, and radiology investigation from October 2007 to December 2010. Three different CT scoring systems including CT severity index （CTSI）, Modified CT severity index （MCTSI） and Extrapancreatic Inflammation on CT score （EPIC）, were used for the determine of PPC, while the predictive values of these three CT scoring systems in the presence of PPC were analyzed by the ROC curve. Results Forty-eight patients （29.6%） were observed the formation of PPC. The scores of CTSI, MCTSI, EPIC and the occurrence rate of ascites in PPC group were significantly higher than those in non-PPC group with One-way ANOVA analysis. Among the three CT scoring systems, EPIC score showed a larger area under ROC curve （AUC=O. 914） than CTSI （AUC=0. 674） and MCTSI （AUC=O. 72） did. Conclusion EPIC scoring system has better prediction of PPC in SAP patients than CTSI and MCTSI.