2012年亚特兰大急性胰腺炎严重程度分类的临床特征研究

Clinical characteristics of revised Atlanta acute pancreatitis severity classification in 2012

目的比较1992年和2012年亚特兰大急性胰腺炎(AP)严重程度分类的临床特征有无差异。方法回顾性分析广西医科大学第一附属医院近3年的AP患者临床资料,分别按1992年和2012年AP分类标准将患者分为轻症组(MAP组)、重症组(SAP组)及轻度组(MAP1组)、中度组(MSAP组)、重度组(SAP1组)。比较两种分类方法的临床资料有无差异。结果纳入的162例AP患者中,男115例,女47例,平均发病年龄(48.62±15.37)岁,女性发病年龄高于男性(P=0.006),病因以胆源性、特发性及饱餐后为主,胆源性AP以女性为主(P<0.001)。不同的性别、年龄段及病因的住院日、住院费用差异均无统计学意义(P均>0.05)。MAP组及SAP组的性别、年龄、病因分布差异均无统计学意义(P均>0.05)。MSAP组的女性比例、发病年龄及胆源性比例均低于MAP1组及SAP1组。各组的住院日及住院费用随AP严重程度升高而升高,且SAP1组>SAP组(P均<0.001)。结论 2012年AP严重程度分类标准下,不同AP严重程度的临床特征有一定的差异,较1992年分类标准更有临床指导意义。

Objective To study the clinical characteristics of different acute pancreatitis （AP） severity classifications.Methods Medical records and data of 166 AP patients who were admitted in the first affiliated hospital of Guangxi Medical University from Oct.2009 to Sep.2012 were reviewed and analyzed.Patients were divided into mild （MAP） and severe （SAP） groups according to Atlanta classification in 1992,and were divided into mild （MAP1）,moderately severe （MSAP）,and severe （SAP1） groups according to Atlanta classification in 2012.Clinical data were compared among different groups.Results Among the 162 patients （mean age 48.62 ± 15.37 years old,115 males and 47 females）,there were 75 patients with MAP and 87 SAP,while 75 MAP1,63 MSAP and 24 SAP1.Mean age of female was older than that of male （P =0.006）.Three main causes of AP were biliary,idiopathic and overeating.Mean age and the rate of female were higher than those of male in biliary AP （P ＜ 0.001）.There was no significant difference in length of hospital stay and hospitalization costs among different gender,age and etiologic groups （P ＞ 0.05）.There was no significant difference in gender,age and etiology between MAP group and SAP group （P ＞0.05）.The rates of female,mean age and biliary AP of MSAP group were lower than those of MAP1 group and SAP1 group （P ＜ 0.05）.Conclusion There is different among different severity of acute pancreatitis according to new acute pancreatitis classification,which has important directive significance in clinic.