BISAP评分在重症急性胰腺炎预后评估中的应用价值

Application Value of BISAP Score in Prognosis Evaluation of Severe Acute Pancreatitis

目的探究重症急性胰腺炎应用BISAP评分(Bedside Index for Severity in AP,BISAP)的预后价值。方法此次实验对象全部选自2016年7月-2018年10月期间接收的198例重症急性胰腺炎患者,用BISAP评分对其胸膜渗出、血尿素氮、全身炎症反应综合征、意识障碍以及年龄五项指标进行综合评估,并对比该评分和APACHE II评分对预测胰腺坏死、机体脏器功能衰竭、死亡的价值,以及对预后的影响。结果 198例患者中,34. 34%器官功能衰竭,胰腺坏死为48. 99%。对器官功能衰竭、胰腺坏死患者的BISAP评分、APACHE II评分进行AUC预测,以3分为最佳截点,BISAP评分的阴性预测值、阳性预测值、敏感性、特异性均优于APACHE II评分,差异有统计学意义(P <0. 05)。BISAP评分的预计死亡率为12. 12%,实际死亡率为11. 62%,差异无统计学意义(P> 0. 05);APACHE II评分的预计死亡率为9. 09%,实际死亡率为11. 62%,差异有统计学意义(P <0. 05);BISAP评分的预计死亡率和APACHE II评分差异有统计学意义(P <0. 05)。结论对重症急性胰腺炎患者应用BISAP评分进行评估的效果显著优于APACHE II评分,能够有效预测胰腺坏死和器官功能衰竭现象,可对患者预后进行有效评估,其临床应用价值较高。

Objective To investigate the prognostic value of bedside index for severity in AP in severe acute pancreatitis. Methods All of the subjects were selected from 198 patients with severe acute pancreatitis who were admitted to our hospital from July 2016 to October 2018. The BISAP score was used for pleural effusion,blood urea nitrogen,systemic inflammatory response syndrome,and disturbance of consciousness. Five indicators of age were comprehensively evaluated,and the score and APACHE II score were compared to predict pancreatic necrosis,organ dysfunction,death,and prognosis.Results Of the 198 patients,34. 34% had organ failure and pancreatic necrosis was 48. 99%. The AUC prediction was performed on the BISAP score and APACHE II score of patients with organ failure and pancreatic necrosis. The scores were divided into 3 best cut-off points. The negative predictive value,positive predictive value,sensitivity and specificity of BISAP score were better than APACHE II score. The difference was statistically significant( P < 0. 05). The estimated mortality rate of BISAP score was 12. 12%,and the actual mortality rate was 11. 62%. The difference was not statistically significant( P >0. 05). The predicted mortality rate of APACHE II score was 9. 09%,and the actual mortality rate was 11. 62%. The difference was statistically significant( P < 0. 05). There was a statistically significant difference between the predicted mortality rate of the BISAP score and the APACHE II score( P < 0. 05). Conclusion The application of BISAP score in patients with severe acute pancreatitis is significantly better than APACHE II score,which can effectively predict pancreatic necrosis and organ failure,and can effectively evaluate the prognosis of patients,and its clinical application value is higher.