无害性胰腺炎评分对高脂血症性胰腺炎的评估

HAP scoring system for evaluation of hyperlipidemic acute pancreatitis

目的 评价无害性胰腺炎评分（harmless acute pancreatitis score,HAPS）评估高脂血症性胰腺炎的价值。方法 回顾性分析2010年3月至2014年3月同济大学附属第十人民医院收治的60名高脂血症性胰腺炎（HLAP）患者资料,以2012亚特兰大分级标准定义急性胰腺炎严重程度,计算HAPS评分、绘制受试者工作特征曲线（ROC）并计算曲线下面积（AUC）以分析HAPS对HLAP严重度的评估价值。结果 60例HLAP患者中,39例（65%）患者诊断为无害性胰腺炎,21例（35%）患者诊断为非无害性胰腺炎;HAPS评分预测非重症急性胰腺炎的特异性为75%（95%CI：50.9～91.3%）,阳性预测值87.2%（95%CI：72.6～95.7%）,AUC为0.8（95%CI：0.677～0.892）;HAP评分异常患者发生不良结局的风险增高。结论 HAPS能简单准确预测轻症高脂血症性胰腺炎。

Objective To assess the application of harmless acute pancreatitis score （HAPS） in evaluation of hyperlipidemic acute pancreatitis （HLAP）. Methods A total of 60 patients with HLAP were enrolled between March 2010 and March 2014. The 2012 revision of Atlanta classification of acute pancreatitis was applied to classified acute pancreatitis as mild acute pancreatitis, moderately severe acute pancreatitis and severe acute pancreatitis （SAP）. HAPS scores were used to evaluate the HLAP patients, and the area under the curve （AUC） of receiver operator characteristic curve （ROC） was used to predict the severity of the disease. Results Among all patients, 39 （65%） were diagnosed as harmless acute pancreatitis and 21 （35%） were as non-harmless clinical course. HAPS score predicted the non-severe course of HLAP with a specificity of 75% （95% C150.9%-91.3% ）, positive predictive value of 87.2% （95% CI 72.6%- 95.7% ） and AUC of HAPS in predicting non- severe HLAP was 0. 8 （ 95% CI 0. 677 - 0. 892, P 〈 0. 05 ）. Patients with non-harmless acutepancreatitis had a higher risk of poorer prognosis compared to those with harmless acute pancreatitis. Conclusion Harmless acute pancreatitis score is simple and effective for predicting the non-severe course of hypedipidemic acute pancreatitis.