急性胰腺炎严重程度床边指数评分联合D-二聚体对高脂血症性急性胰腺炎严重程度的早期预测价值

Early predictive value of BISAP score combined with D-dimer in the severity of hyperlipidemic acute pancreatitis

目的探讨急性胰腺炎严重程度床边指数(BISAP)评分联合D-二聚体对高脂血症性急性胰腺炎(HLAP)严重程度的早期预测价值.方法选择2016-01-01~2018-12-31郑州大学第一附属医院急诊科收治的HLAP患者108例进行回顾性研究,共纳入101例,按病情严重程度分为两组:重度HLAP组(HL-SAP组,28例)和轻、中度组(NHL-SAP组,73例).评估患者入院24 h内的BISAP评分,收集患者入院24 h内的D-二聚体水平,比较两组数据差异有无统计学意义.绘制受试者工作特征(ROC)曲线,研究BISAP评分、D-二聚体及B-D(BISAP评分和D-二聚体)联合对HLAP严重程度的预测价值.结果BISAP评分和D-二聚体水平随着HLAP严重程度的加重而升高(P<0.05),且BISAP评分和D-二聚体水平间存在正相关性(r=0.245,P<0.05);BISAP评分、D-二聚体和B-D联合对HLAP严重程度的ROC曲线结果显示,ROC曲线下面积(AUC)分别为0.813、0.686、0.859,差异均有统计学意义(P<0.01),B-D联合评估优于BISAP评分或D-二聚体的单独评估.结论BISAP评分及D-二聚体均能较好预测HLAP严重程度,且二者联合对HLAP病情的早期预测价值更高.

Objective To investigate the early predictive value of bedside index for severity in acute pancreatitis(BISAP)score combined with D-dimer in the severity of hyperlipidemic acute pancreatitis(HLAP).Methods A retrospective study was performed on 108 HLAP patients admitted to the Emergency Department of the First Affiliated Hospital of Zhengzhou University from January 1,2016 to December 31,2018.A total of 101 patients were included and divided into two groups according to the severity of the disease:severe hyperlipidemic acute pancreatitis group(28 cases in the HL-SAP group)and mild to moderate hyperlipidemic acute pancreatitis group(73 cases in the NHL-SAP group).The BISAP scores within 24 hours after admission were evaluated,D-dimer levels within 24 hours after admission were collected,and the differences of data between the two groups were compared.The receiver operating characteristic(ROC)curves were drawn,and the predictive value of BISAP score,D-dimer and B-D(BISAP score and D-dimer)in the severity of HLAP was studied.Results BISAP score and D-dimer level increased with the severity of HLAP(P<0.05),and there was a positive correlation between BISAP score and D-dimer level(r=0.245,P<0.05);The results of ROC curve of BISAP score,D-dimer and B-D for the severity of HLAP showed that the area under the ROC curve(AUC)was 0.813,0.686,and 0.859,respectively,and the differences were statistically significant(P<0.01).Conclusion Both BISAP score and D-dimer can better predict the severity of HLAP,and the combination of BISAP score and D-dimer is more valuable for early prediction of HLAP disease.