急性胰腺炎评分系统的研究进展

Research advances in acute pancreatitis scoring system

急性胰腺炎(AP)是临床常见的危重疾病,发病率不断升高。虽然大多数患者是轻症胰腺炎,但重症胰腺炎的病死率仍偏高,因此亟需一些早期、简便、精确的临床评分系统来判断AP严重程度,以此便于进行有效的疾病管理和对症治疗而降低患者病死率。目前有大量研究证实,Ranson评分、APACHEⅡ评分、BISAP评分、CTSI评分、某些血清学指标等评分系统已用于评估AP的严重程度及预后,但均有一定的局限性。本文对现有的评分系统、单一血清学指标及其相关的改良评分系统近年来的研究进展作一概述。通过文献复习认为目前尚无任何单一评分系统或某一指标能够覆盖AP诊治的全过程,对AP严重程度作出准确的判断,需要开发新的评分系统或联合各项指标综合评定。

Acute pancreatitis(AP)is a severe disease with an increasing incidence rate in clinical practice.Although most patients have mild pancreatitis,the fatality rate of severe pancreatitis remains at a relatively high level,and therefore,early-stage,simple,and accurate clinical scoring systems are urgently needed to determine the severity of AP,so as to facilitate effective disease management and symptomatic treatment and reduce the fatality rate of patients.At present,a large number of studies have demonstrated that the scoring systems such as Ranson score,APACHEⅡ score,BISAP score,CTSI score,and some serological markers have been used to evaluate the severity and prognosis of AP,but all of them have certain limitations.This article reviews the research advances in the existing scoring systems,single serological markers,and related modified scoring systems in recent years.Through a literature review,it is concluded that there is no a single scoring system or a single indicator that can cover the whole process of AP diagnosis and treatment and accurately judge the severity of AP,and therefore,it is necessary to develop a new scoring system or combine various indicators for comprehensive evaluation.