急性胰腺炎严重程度预测

Severity Prediction of Acute Pancreatitis

急性胰腺炎是多种病因导致胰酶在胰腺内被激活后引起胰腺组织自身消化、水肿、出血甚至坏死的炎症反应。临床以急性上腹痛、恶心、呕吐、发热和血胰酶增高等为特点。病变程度轻重不等,轻者以胰腺水肿为主,临床多见,病情常呈自限性,愈后良好,又称为轻症急性胰腺炎。少数重症患者的胰腺出血坏死,常继发感染、腹膜炎和休克等,病死率高,称为重症急性胰腺炎。随着该疾病临床上的发展出现了各种对急性胰腺炎严重程度的预测因子,本文从急性胰腺炎患者因素、免疫因素、细胞因子因素、生化因素、影像因素、评分系统、对目前临床上广泛应用且研究的预测因子进行总结。

Acute pancreatitis is an inflammatory response caused by pancreatic enzymes to be activated in the pancreas, causing self-digestion, edema, bleeding and even necrosis of pancreatic tissue. Clinically, it is characterized by acute epigastric pain, nausea, vomiting, fever, and increased blood and pan-creatic enzymes. The degree of lesions varies from mild to severe, mainly pancreatic edema, which is more common clinically, and the condition is often self-limited, and the recovery is good, which is also known as mild acute pancreatitis. A small number of severe pancreatic hemorrhage necrosis, often have secondary infection, peritonitis and shock, etc., and the mortality rate is high, which is called severe acute pancreatitis. With the clinical development of the disease, various predictors of the severity of acute pancreatitis have emerged, and this article summarizes the predictors that are widely used and studied in clinical practice from the patient factors, immune factors, cytokine fac-tors, biochemical factors, imaging factors, scoring systems, and currently widely used and studied in acute pancreatitis.