改良CT严重程度指数联合BISAP评分对早期急性胰腺炎预测价值

The Value of Modified CT Severity Index Combined with BISAP Score for Acute Pancreatitis

目的 比较并分析急性胰腺炎(AP)严重程度的三种评分系统即改良CT严重程度指数(MCTSI)评分、急性胰腺炎床边严重程度指数(BISAP)评分及两者联合评分对AP严重程度的预测价值,并对重症急性胰腺炎(SAP)患者治疗的独立危险因素进行探讨。方法 回顾性分析2019年12月至2020年10月在本院确诊为AP的患者79例,其中诊断为SAP的患者31例,搜集所有患者MCTSI评分、BISAP评分及两者联合评分;利用受试者工作特征(ROC)曲线比较三者预测AP严重程度的作用,使用二元Logistic回归分析研究SAP患者治疗的危险因素。结果 MCTSI评分、BISAP评分及两者联合评分的曲线下面积(AUC)值分别为0.848、0.817、0.894,提示MCTSI评分联合BISAP评分对AP严重程度的预测价值较单一评分系统高。二元Logistic回归分析显示MCTSI评分[比值比(OR)=1.12]、BISAP评分(OR=1.08)及两者联合评分(OR=1.52)均为SAP患者治疗的独立危险因素。结论 MCTSI联合BISAP评分对AP严重程度的预测价值较单一评分系统高;MCTSI评分、BISAP评分及两者联合评分均为SAP患者治疗的独立危险因素。

Objective To compare the predictive value of modified computed tomography severity index(MCTSI),bedside index for severity in acute pancreatitis(BISAP) and their combined score,and to explore the independent risk factors for the treatment of patients with severe acute pancreatitis(SAP).Methods 79 patients diagnosed as AP in our hospital from December 2019 to October 2020 were analyzed retrospectively,including 31 patients diagnosed as SAP.MCTSI score,BISAP score and their combined score were collected.The receiver operator characteristic(ROC) curve was used to compare the three factors in predicting the severity of AP,and the binary Logistic regression analysis were used to study the risk factors affecting the prognosis of SAP patients.Results The AUC results of MCTSI,BISAP score and their combination were 0.848,0.817 and 0.894,respectively,suggesting that the predictive value of MCTSI combined with BISAP score for AP severity was higher than that of single scoring system.Binary Logistic regression analysis showed that MCTSI score [odds ratio(OR) = 1.12],BISAP score [odds ratio(OR) = 1.08] and their combination score [odds ratio(OR) = 1.52] were independent risk factors for SAP patients.Conclusion MCTSI combined with BISAP score has higher predictive value for AP severity than other single scoring systems.MCTSI score,BISAP score and their combined score are independent risk factors for treatment of SAP patients.