摘要
目的探讨重症急性胰腺炎(SAP)患者CT检查时的3种评分方法对疾病预后的评估价值。方法SAP患者240例,根据预后分为预后不良组(n=80)和预后良好组(n=160),应用64排多层螺旋CT于入院第2天予腹部CT检查,分别进行CT严重指数(CTSI)、修正CT严重指数(MCTSI)和胰腺外炎症CT(EPIC)评分;同时收集两组患者入院时清晨空腹静脉血,应用酶联免疫法检测血清C-反应蛋白(CRP)、降钙素原(PCT)、白介素-6(IL-6)、胰蛋白酶激活肽(TAP)、血管生成张素2(Ang-2)及D-二聚体(D-D)水平,分析3种CT评分与血清学指标的相关性;采用ROC工作曲线法分析3种CT评分对SAP预后的评估价值。结果SAP预后不良组患者MCTSI、EPIC和CTSI评分及血清CRP、PCT、IL-6、D-D、TAP和Ang-2水平均明显高于预后良好组,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,CTSI、MCTIS和EPIC评分与SAP患者血清中CRP、PCT、IL-6、D-D、TAP和Ang-2水平均呈正相关,差异有统计学意义(P<0.05);ROC曲线分析结果显示,EPIC、MCTIS和CTSI评分联合应用较各单独CT评分的ROC曲线下面积(AUC)、灵敏度和特异性高,差异有统计学意义(P<0.05)。结论SAP患者EPIC、MCTIS和CTSI评分与血清学指标相关,且3种CT评分联合应用对SAP预后有较高价值。
Objective To explore the relationship between CT severity index(CTSI),modified CT severity index(MCTSI),and CT(EPIC)scores of extrapancreatic inflammation and serological indicators in patients with severe acute pancreatitis(SAP)and their prognostic value.Methods A total of 240 SAP patients were included.According to the prognosis,they were divided into a poor prognosis group(n=80)and a good prognosis group(n=160).A 64-slice spiral CT was used to perform abdominal CT examinations on patients 2 days after admission,and the CT results were scored by MCTSI,EPIC,and CTSI.Fasting venous blood was collected on the morning in 2 groups,and serum levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),trypsin activating peptide(TAP),angiotensin 2(ANG-2),and D-dimer(D-D)were detected by enzyme-linked immunoassay.The correlation between three CT scores and serological indexes was analyzed.ROC working curve method was used to analyze the value of 3 CT scores for SAP prognosis.Results The MCTSI,EPIC,and CTSI scores and serum CRP,PCT,IL-6,D-D,TAP,and Ang-2 levels in the SAP poor prognosis group were significantly higher than those in the good prognosis group,and the difference was statistically significant(P<0.05).The results of Pearson correlation analysis showed that CTSI,MCTIS,and EPIC scores were positively correlated with the levels of CRP,PCT,IL-6,D-D,TAP,and Ang-2 in serum of SAP patients,and the difference was statistically significant(P<0.05).ROC curve analysis results show that the combined EPIC,MCTIS,and CTSI scores have higher sensitivity and specificity than the area under the ROC curve(AUC)of each individual CT score.Conclusion The EPIC,MCTIS,and CTSI scores of SAP patients are closely related to serological indicators,and the combination of the three CT scores has high clinical application value in predicting the poor prognosis of SAP patients.
作者
王霞
沈爱武
刘海云
徐珊
WANG Xia;SHEN Aiwu;LIU Haiyun;XU Shan(Department of Gastroenterology,Rugao Hospital Affiliated to Nantong University,Rugao 226500,Jiangsu,China)
出处
《贵州医科大学学报》
CAS
2021年第12期1483-1488,共6页
Journal of Guizhou Medical University
基金
江苏省医药学会科研基金(Q2018105)。
关键词
急性重症胰腺炎
CT评分
预后
血清学指标
相关性
acute severe pancreatitis
CT score
prognosis
serological indicators
correlation
