BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizin...BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizing the individuals at risk of developing POF early in the HTG-AP process is a vital for improving outcomes.Bedside index for severity in acute pancreatitis(BISAP),a simple parameter that is obtained 24 h after admission,is an ideal index to predict HTG-AP severity;however,the suboptimal sensitivity limits its clinical application.Hence,current clinical scoring systems and biochemical parameters are not sufficient for predicting HTG-AP severity.AIM To elucidate the early predictive value of red cell distribution width(RDW)for POF in HTG-AP.METHODS In total,102 patients with HTG-AP were retrospectively enrolled.Demographic and clinical data,including RDW,were collected from all patients on admission.RESULTS Based on the Revised Atlanta Classification,37(33%)of 102 patients with HTG-AP were diagnosed with POF.On admission,RDW was significantly higher in patients with HTG-AP and POF than in those without POF(14.4%vs 12.5%,P<0.001).The receiver operating characteristic curve demonstrated a good discrim-inative power of RDW for POF with a cutoff of 13.1%,where the area under the curve(AUC),sensitivity,and specificity were 0.85,82.4%,and 77.9%,respectively.When the RDW was≥13.1%and one point was added to the original BISAP to obtain a new BISAP score,we achieved a higher AUC,sensitivity,and specificity of 0.89,91.2%,and 67.6%,respectively.CONCLUSION RDW is a promising predictor of POF in patients with HTG-AP,and the addition of RDW can promote the sensitivity of BISAP.展开更多
AIM: To assess the value of plasma melatonin in pre-dicting acute pancreatitis when combined with the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and bedside index for severity in acute pancreatitis ...AIM: To assess the value of plasma melatonin in pre-dicting acute pancreatitis when combined with the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and bedside index for severity in acute pancreatitis (BISAP) scoring systems. METHODS: APACHEⅡ and BISAP scores were calculated for 55 patients with acute physiology (AP) in the first 24 h of admission to the hospital. Additionally, morning (6:00 AM) serum melatonin concentrations were measured on the first day after admission. According to the diagnosis and treatment guidelines for acute pancreatitis in China, 42 patients suffered mild AP (MAP). The other 13 patients developed severe AP (SAP). A total of 45 healthy volunteers were used in this study as controls. The ability of melatonin and the APACHEⅡ and BISAP scoring systems to predict SAP was evaluated using a receiver operating characteristic (ROC) curve. The optimal melatonin cutoff concentration for SAP patients, based on the ROC curve, was used to classify the patients into either a high concen-tration group (34 cases) or a low concentration group (21 cases). Differences in the incidence of high scores, according to the APACHEⅡ and BISAP scoring sys- tems, were compared between the two groups. RESULTS: The MAP patients had increased melatonin levels compared to the SAP (38.34 ng/L vs 26.77 ng/L) (P = 0.021) and control patients (38.34 ng/L vs 30.73 ng/L) (P = 0.003). There was no significant difference inmelatoninconcentrations between the SAP group and the control group. The accuracy of determining SAP based on the melatonin level, the APACHEⅡ score and the BISAP score was 0.758, 0.872, and 0.906, respectively, according to the ROC curve. A melatonin concentration ≤ 28.74 ng/L was associated with an increased risk of developing SAP. The incidence of high scores (≥ 3) using the BISAP system was significantly higher in patients with low melatonin concentration (≤ 28.74 ng/L) compared to patients with high melatonin concentration (> 28.74 ng/L) (42.9% vs 14.7%, P = 0.02). The incidence of high APACHEⅡ scores (≥ 10) between the two groups was not significantly different. CONCLUSION: The melatonin concentration is closely related to the severity of AP and the BISAP score. Therefore, we can evaluate the severity of disease by measuring the levels of serum melatonin.展开更多
目的探讨基于床旁严重度指数(Bedside Index of Severity in Acute Pancreatitis,BISAP)评分系统的护理干预对重症胰腺炎患者自我护理能力、生活质量的影响。方法方便选取2022年1月-2023年5月福建医科大学附属协和医院收治的88例重症胰...目的探讨基于床旁严重度指数(Bedside Index of Severity in Acute Pancreatitis,BISAP)评分系统的护理干预对重症胰腺炎患者自我护理能力、生活质量的影响。方法方便选取2022年1月-2023年5月福建医科大学附属协和医院收治的88例重症胰腺炎患者为研究对象,接随机数表法分为对照组和BISAP评分组,各44例。对照组接受临床重症胰腺炎患者的常规护理,BISAP评分组接受基于BISAP评分系统的护理干预。对比两组患者的护理1周、护理2周后自我护理能力、生活质量及护理满意度。结果护理1周、护理2周时,BISAP评分组的自我护理能力评估量表中对健康知识掌握、自我认同、自我责任感、自我护理能力等维度评分值均高于对照组,差异有统计学意义(P均<0.05);BISAP评分组的生活质量综合评估量表中躯体功能、心理功能、社会功能、物质生活状态等维度评分值均高于对照组,差异有统计学意义(P均<0.05)。出院当日,BISAP评分组的平均护理满意度评分(94.76±5.43)分高于对照组(84.93±8.05)分,差异有统计学意义(t=6.715,P<0.05)。结论基于BISAP评分系统的护理干预应用于重症胰腺炎患者中,可积极提升其自我护理能力及生活质量,同时有助于护理满意度的优化。展开更多
目的研究单核细胞计数/高密度脂蛋白胆固醇比值(MHR)和急性胰腺炎(AP)的相关性.方法选取AP患者100例为AP组,收集其临床资料,并对所有患者进行MHR及急性胰腺炎严重程度床边指数(BISAP)评分计算.同时选取健康体检者30例为对照(CON)组.分析...目的研究单核细胞计数/高密度脂蛋白胆固醇比值(MHR)和急性胰腺炎(AP)的相关性.方法选取AP患者100例为AP组,收集其临床资料,并对所有患者进行MHR及急性胰腺炎严重程度床边指数(BISAP)评分计算.同时选取健康体检者30例为对照(CON)组.分析MHR与AP之间的相关性.结果AP组MHR高于CON组(P<0.05),MHR与BISAP评分正相关(p=0.460,P<0.05);MHR为AP的独立危险因素[OR=1.018,95%CI(1.009,1.026)];ROC曲线分析显示MHR预测AP的曲线下面积(area under curve,AUC)为0.913,截断值为390.3时,预估AP的敏感度和特异度分别为83%和90%.结论MHR是AP的危险因素,对AP的发生具有预测价值.展开更多
目的比较BISAP评分与Ranson’s评分在预测急性胰腺炎(acute pancreatitis,AP)的严重度及病死率方面的运用价值。方法以2007年6月到2010年10月入住本院的AP患者为研究对象,资料完整诊断明确者共有652例,采用BISAP(the bedside index for ...目的比较BISAP评分与Ranson’s评分在预测急性胰腺炎(acute pancreatitis,AP)的严重度及病死率方面的运用价值。方法以2007年6月到2010年10月入住本院的AP患者为研究对象,资料完整诊断明确者共有652例,采用BISAP(the bedside index for severity in AP)评分与Ranson’s评分比较,受试者工作特性曲线(receiver-operating curve,ROC)行回顾性分析,在预计AP的严重度及病死率方面的差异。结果在652例患者中,通过发病48 h内出现器官衰竭确定为重症者108例(16.6%),共死亡21例(3.2%),BISAP评分≥3分的44例(6.7%),入院48 h内Ranson’s评分≥3分者213例(32.7%)。BISAP与Ranson’s评分二者在评价预后方面的差异有统计学意义,其中严重度的曲线下面积BISAP、Ranson’s评分系统分别为:0.846(95%CI 0.808～0.883),0.771(95%CI 0.722～0.820);死亡率分别是:0.809(95%CI 0.699～0.920),0.762(95%CI 0.638～0.885)。结论 BISAP评分系统在急性胰腺炎早期,针对患者严重度、死亡率的预后评估的准确性明显高于Ranson’s评分,是目前最简易、及时、连续性强并且对患者而言经济花费少的评分系统,可在临床广泛推广。展开更多
目的:研究BISAP(bedside index for severity in AP)评分联合凝血指标对急性胰腺炎(acute pancreatitis,AP)严重程度评估的意义.方法:回顾2008-2012年中国医科大学附属盛京医院收治的166例AP患者的临床资料.对所有患者进行入院24h的BISA...目的:研究BISAP(bedside index for severity in AP)评分联合凝血指标对急性胰腺炎(acute pancreatitis,AP)严重程度评估的意义.方法:回顾2008-2012年中国医科大学附属盛京医院收治的166例AP患者的临床资料.对所有患者进行入院24h的BISAP、APACHE-Ⅱ评分,48h的Ranson's及发病72h内CTSI评分,入院24h内抽取静脉血测定部分凝血活酶活化时间、凝血酶原时间、D-二聚体(D-dimer)、纤维蛋白原及血小板水平.分析凝血指标及BISAP评分对AP严重程度判断的意义,并通过ROC曲线分析二者联合对AP严重程度评估的意义.结果:多因素Logistic回归分析发现,D-dimer对AP严重程度评估具有独立预测意义;随着BISAP评分增加,SAP的比率增加;BISAP评分系统评估AP严重程度以2为临界点时Youden指数最大(0.541),ROC曲线下面积为0.836(0.776-0.896),并不逊于传统评分系统;BISAP评分系统联合D-dimer能更好地评估AP患者的严重程度.结论:BISAP是临床判断AP轻重程度的简单有效的指标,将BISAP与D-dimer联合应用使得对AP严重程度的评估更为准确.展开更多
目的比较BISAP评分与Ranson评分在预测急性胰腺炎(acute pancreatitis,AP)的严重程度、死亡结局方面的应用价值。方法运用BISAP(bedside index for severity in AP)评分与Ranson评分对124例AP患者进行回顾性评分,比较轻症组与重症组、...目的比较BISAP评分与Ranson评分在预测急性胰腺炎(acute pancreatitis,AP)的严重程度、死亡结局方面的应用价值。方法运用BISAP(bedside index for severity in AP)评分与Ranson评分对124例AP患者进行回顾性评分,比较轻症组与重症组、死亡组与存活组的评分差异,比较高分组与低分组之间重症急性胰腺炎(SAP)发生率、病死率的差异。结果重症组与轻症组、死亡组与存活组的BISAP及Ranson评分差异均有统计学意义(P<0.01)。对于Ranson高分组(≥3分)和低分组(<3分)患者SAP发生率间差异有统计学意义(P<0.01),两组病死率差异无统计学意义(P>0.05)。对于BISAP高分组(≥3分)与低分组(<3分)的SAP及病死率间差异均有统计学意义(P<0.01)。结论 BISAP评分与Ranson评分对于判断AP严重程度均具有重要参考意义。BISAP简便易行,能够早期对AP患者进行死亡风险评估。展开更多
基金the Science and Technology Program of Guiyang Baiyun District Science and Technology Bureau.No.[2017]50Science and Technology Program of Guiyang Municipal Bureau of Science and Technology,No.[2018]1-72Science and Technology Fund Project of Guizhou Provincial Health Commission,No.gzwkj2021-127.
文摘BACKGROUND Compared with patients with other causes of acute pancreatitis,those with hypertriglyceridemia-induced acute pancreatitis(HTG-AP)are more likely to develop persistent organ failure(POF).Therefore,recognizing the individuals at risk of developing POF early in the HTG-AP process is a vital for improving outcomes.Bedside index for severity in acute pancreatitis(BISAP),a simple parameter that is obtained 24 h after admission,is an ideal index to predict HTG-AP severity;however,the suboptimal sensitivity limits its clinical application.Hence,current clinical scoring systems and biochemical parameters are not sufficient for predicting HTG-AP severity.AIM To elucidate the early predictive value of red cell distribution width(RDW)for POF in HTG-AP.METHODS In total,102 patients with HTG-AP were retrospectively enrolled.Demographic and clinical data,including RDW,were collected from all patients on admission.RESULTS Based on the Revised Atlanta Classification,37(33%)of 102 patients with HTG-AP were diagnosed with POF.On admission,RDW was significantly higher in patients with HTG-AP and POF than in those without POF(14.4%vs 12.5%,P<0.001).The receiver operating characteristic curve demonstrated a good discrim-inative power of RDW for POF with a cutoff of 13.1%,where the area under the curve(AUC),sensitivity,and specificity were 0.85,82.4%,and 77.9%,respectively.When the RDW was≥13.1%and one point was added to the original BISAP to obtain a new BISAP score,we achieved a higher AUC,sensitivity,and specificity of 0.89,91.2%,and 67.6%,respectively.CONCLUSION RDW is a promising predictor of POF in patients with HTG-AP,and the addition of RDW can promote the sensitivity of BISAP.
基金Supported by The Wenzhou Municipal Science and Technology Commission Major Projects Funds,No.20090006
文摘AIM: To assess the value of plasma melatonin in pre-dicting acute pancreatitis when combined with the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and bedside index for severity in acute pancreatitis (BISAP) scoring systems. METHODS: APACHEⅡ and BISAP scores were calculated for 55 patients with acute physiology (AP) in the first 24 h of admission to the hospital. Additionally, morning (6:00 AM) serum melatonin concentrations were measured on the first day after admission. According to the diagnosis and treatment guidelines for acute pancreatitis in China, 42 patients suffered mild AP (MAP). The other 13 patients developed severe AP (SAP). A total of 45 healthy volunteers were used in this study as controls. The ability of melatonin and the APACHEⅡ and BISAP scoring systems to predict SAP was evaluated using a receiver operating characteristic (ROC) curve. The optimal melatonin cutoff concentration for SAP patients, based on the ROC curve, was used to classify the patients into either a high concen-tration group (34 cases) or a low concentration group (21 cases). Differences in the incidence of high scores, according to the APACHEⅡ and BISAP scoring sys- tems, were compared between the two groups. RESULTS: The MAP patients had increased melatonin levels compared to the SAP (38.34 ng/L vs 26.77 ng/L) (P = 0.021) and control patients (38.34 ng/L vs 30.73 ng/L) (P = 0.003). There was no significant difference inmelatoninconcentrations between the SAP group and the control group. The accuracy of determining SAP based on the melatonin level, the APACHEⅡ score and the BISAP score was 0.758, 0.872, and 0.906, respectively, according to the ROC curve. A melatonin concentration ≤ 28.74 ng/L was associated with an increased risk of developing SAP. The incidence of high scores (≥ 3) using the BISAP system was significantly higher in patients with low melatonin concentration (≤ 28.74 ng/L) compared to patients with high melatonin concentration (> 28.74 ng/L) (42.9% vs 14.7%, P = 0.02). The incidence of high APACHEⅡ scores (≥ 10) between the two groups was not significantly different. CONCLUSION: The melatonin concentration is closely related to the severity of AP and the BISAP score. Therefore, we can evaluate the severity of disease by measuring the levels of serum melatonin.
文摘目的探讨基于床旁严重度指数(Bedside Index of Severity in Acute Pancreatitis,BISAP)评分系统的护理干预对重症胰腺炎患者自我护理能力、生活质量的影响。方法方便选取2022年1月-2023年5月福建医科大学附属协和医院收治的88例重症胰腺炎患者为研究对象,接随机数表法分为对照组和BISAP评分组,各44例。对照组接受临床重症胰腺炎患者的常规护理,BISAP评分组接受基于BISAP评分系统的护理干预。对比两组患者的护理1周、护理2周后自我护理能力、生活质量及护理满意度。结果护理1周、护理2周时,BISAP评分组的自我护理能力评估量表中对健康知识掌握、自我认同、自我责任感、自我护理能力等维度评分值均高于对照组,差异有统计学意义(P均<0.05);BISAP评分组的生活质量综合评估量表中躯体功能、心理功能、社会功能、物质生活状态等维度评分值均高于对照组,差异有统计学意义(P均<0.05)。出院当日,BISAP评分组的平均护理满意度评分(94.76±5.43)分高于对照组(84.93±8.05)分,差异有统计学意义(t=6.715,P<0.05)。结论基于BISAP评分系统的护理干预应用于重症胰腺炎患者中,可积极提升其自我护理能力及生活质量,同时有助于护理满意度的优化。
文摘目的研究单核细胞计数/高密度脂蛋白胆固醇比值(MHR)和急性胰腺炎(AP)的相关性.方法选取AP患者100例为AP组,收集其临床资料,并对所有患者进行MHR及急性胰腺炎严重程度床边指数(BISAP)评分计算.同时选取健康体检者30例为对照(CON)组.分析MHR与AP之间的相关性.结果AP组MHR高于CON组(P<0.05),MHR与BISAP评分正相关(p=0.460,P<0.05);MHR为AP的独立危险因素[OR=1.018,95%CI(1.009,1.026)];ROC曲线分析显示MHR预测AP的曲线下面积(area under curve,AUC)为0.913,截断值为390.3时,预估AP的敏感度和特异度分别为83%和90%.结论MHR是AP的危险因素,对AP的发生具有预测价值.
文摘目的:研究BISAP(bedside index for severity in AP)评分联合凝血指标对急性胰腺炎(acute pancreatitis,AP)严重程度评估的意义.方法:回顾2008-2012年中国医科大学附属盛京医院收治的166例AP患者的临床资料.对所有患者进行入院24h的BISAP、APACHE-Ⅱ评分,48h的Ranson's及发病72h内CTSI评分,入院24h内抽取静脉血测定部分凝血活酶活化时间、凝血酶原时间、D-二聚体(D-dimer)、纤维蛋白原及血小板水平.分析凝血指标及BISAP评分对AP严重程度判断的意义,并通过ROC曲线分析二者联合对AP严重程度评估的意义.结果:多因素Logistic回归分析发现,D-dimer对AP严重程度评估具有独立预测意义;随着BISAP评分增加,SAP的比率增加;BISAP评分系统评估AP严重程度以2为临界点时Youden指数最大(0.541),ROC曲线下面积为0.836(0.776-0.896),并不逊于传统评分系统;BISAP评分系统联合D-dimer能更好地评估AP患者的严重程度.结论:BISAP是临床判断AP轻重程度的简单有效的指标,将BISAP与D-dimer联合应用使得对AP严重程度的评估更为准确.
文摘目的比较BISAP评分与Ranson评分在预测急性胰腺炎(acute pancreatitis,AP)的严重程度、死亡结局方面的应用价值。方法运用BISAP(bedside index for severity in AP)评分与Ranson评分对124例AP患者进行回顾性评分,比较轻症组与重症组、死亡组与存活组的评分差异,比较高分组与低分组之间重症急性胰腺炎(SAP)发生率、病死率的差异。结果重症组与轻症组、死亡组与存活组的BISAP及Ranson评分差异均有统计学意义(P<0.01)。对于Ranson高分组(≥3分)和低分组(<3分)患者SAP发生率间差异有统计学意义(P<0.01),两组病死率差异无统计学意义(P>0.05)。对于BISAP高分组(≥3分)与低分组(<3分)的SAP及病死率间差异均有统计学意义(P<0.01)。结论 BISAP评分与Ranson评分对于判断AP严重程度均具有重要参考意义。BISAP简便易行,能够早期对AP患者进行死亡风险评估。
