急性胰腺炎患者强离子隙在病情严重程度预测中的价值探讨

The value of strong ion gap in predicting the severity of acute pancreatitis

目的探讨急性胰腺炎患者强离子隙在病情严重程度预测中的价值。方法本研究回顾性分析了2010—01～2016—06天津市第五中心医院急性胰腺炎患者186例，分为轻中度组、重度组和对照组，采用Stewart法分析了患者的酸碱失衡相关参数。采用单因素和多因素回归分析比较患者的年龄、性别、APACHEⅡ评分、动脉血气分析结果、生化检测结果、血常规结果及住院期间病死率、住院时间和急诊住院时间与患者疾病严重程度的相关性。结果重度组患者APACHEⅡ评分为18，强阳离子隙为7．88，Na^＋浓度为139，均高于轻中度组和对照组（12，2．11，138；0，0．22，135），是急性胰腺炎患者疾病严重程度的独立预测因子。其中强阳离子隙预测的准确性高达91％，高于APACHEⅡ评分的87％和Na^＋的71％。结论强阳离子隙预测急性胰腺炎患者病情严重程度的准确性极高，有利于对急性胰腺炎患者进行严重程度的分类，能够在临床上给予患者更适当的治疗。

Objective To access the value of strong ion gap （SIG） in predicting the severity of acute pancreatitis patients. Methods 186 acute pancreatitis patients were retrospective analyzed in our hospital ICU from January 2010 to June 2016. The acid - base disturbance was described by using the Stewart analysis. Univariate linear regression analysis and multivariate stepwise analysis were used to analyses the correlation between severity and age, gender, APACHE II value, results of arterial blood gas analysis, biochemical detection results, blood routine examination results, mortality, hospital stay and ICU stay. Results APACHE II score was 18, SIG was 7.88 and Na^＋ level was 139 in patients with severe were higher than mild -to -moderate and control group （12, 2.11, 138 ;0,0.22, 135） and are independent predictor of severity. The accuracy of SIG in predicting severity of acute pancreatitis patients was 91%, higher than APACHE II score （87%） and Na^＋ level （71%）. Conclusion The accuracy of SIG in predicting severity of acute pancreatitis patients is excellent, this may be benefit for classification of acute pancreatitis patients according to severity, and for patients to receive appropriate treatment.