重症急性胰腺炎早期严重程度评估方法及其临床意义

Evaluation method and clinical significance of early severity of severe acute ppancreatitis

重症急性胰腺炎(SAP)是一种急性起病、剧烈腹痛的严重胰腺炎症,常伴有严重的局部和全身并发症,病死率较高。既往研究结果表明,在发病后的首个24 h内,识别SAP病人并进行针对性强化治疗,对于降低并发症发生率及病死率至关重要。此外,为了避免过度医疗及增加病人创伤、经济负担,正确识别轻症急性胰腺炎也同样重要。推荐采用床旁急性胰腺炎严重度指数评分结合C反应蛋白及降钙素原等检测手段作为预测急性胰腺炎危重程度的首选因素及标记物。由于SAP病理生理过程复杂,疾病进展快,影响因素较多,因此仍需进一步地深入研究,以发展更快、更精准的预测SAP手段。

Severe acute pancreatitis(SAP)is a severe pancreatic inflammation with acute onset and intense abdominal pain,accompanied by severe local and systemic complications,which could lead to high mortality.Previous studies have shown that the first 24 hours after the onset of acute pancreatitis is critical for identifying SAP patients and intensifying targeted treatments,to reduce the incidence of complications and mortality.Moreover,accurately identifying mild acute pancreatitis cases is equally critical to avoid overtreatment and extra financial burden for patients.According to both domestic and international research,as well as the experience of our center,the author analyzed numerous multifactorial scoring systems and biochemical markers for predicting severity and recommended to use of the BISAP score combined with C-reactive protein and procalcitonin as the primary predictive factors and markers to predict the severity of acute pancreatitis.However,given SAP's complex pathological process,rapid progression,and numerous influencing factors,further in-depth research is essential for a faster and more accurate prediction of SAP.