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目的探讨重症急性胰腺炎(SAP)患者CT严重指数(CTSI)、修正CT严重指数(MCTSI)与急性胰腺炎严重程度床边指数(BISAP)的相关性。方法前瞻性收集2015年7月至2015年10月期间确诊为急性胰腺炎的患者112例,纳入其中诊断为SAP的患者38例,对其采用两种CT评分标准(CTSI及MCTSI)和BISAP评分标准进行评分。采用SPSS 19.0软件分析两种CT评分结果与BISAP评分结果的相关性,对于观测者的一致性用Kappa检验分析。MCTSI和CTSI分别与BISAP的相关性用Spearman等级相关分析。检验水准α=0.05。结果BISAP评分两位观察者评定结果均为Ⅰ级者3例(8.9%),Ⅱ级者20例(52.6%),Ⅲ级者15例(39.5%),观察者间一致性强(Kappa=1,P<0.01);CTSI评分两位观察者结果均为Ⅰ级者6例(15.8%),Ⅱ级者22例(57.9%),Ⅲ级者10例(26.3%),观察者间一致性较好(Kappa=0.748,95%CI 0.000~0.076,P<0.01);MCTSI评分两位观察者结果均为Ⅰ级者2例(5.3%),Ⅱ级者19例(50.0%),Ⅲ级者17例(44.7%),观察者间一致性较好(Kappa=0.788,95%CI0.000~0.076,P<0.01)。CTSI评分与BISAP评分呈正相关(rs=0.385,P=0.001),MCISI与BISAP评分也呈正相关(rs=0.326,P=0.004)。结论两种CT严重指数评分评价SAP,CTSI评分和MCTSI评分与BISAP评分均趋于正相关,但是相关性都较弱。
Objective To investigate the correlation between CTSI, MCTSI and bedside index (BISAP) in patients with severe acute pancreatitis (SAP). Methods One hundred and twelve patients diagnosed as acute pancreatitis from July 2015 to October 2015 were prospectively collected. Among them, 38 patients were diagnosed as SAP. Two CT scoring criteria (CTSI and MCTSI) and BISAP score Standard score. SPSS 19.0 software was used to analyze the correlation between the two CT scoring results and the BISAP scoring results. The consistency of the observers was analyzed by Kappa test. Correlations between MCTSI and CTSI and BISAP were analyzed using Spearman rank correlation analysis. Test level α = 0.05. Results The BISAP scores of two observers were all grade Ⅰ in 3 cases (8.9%), grade Ⅱ in 20 cases (52.6%) and grade Ⅲ in 15 cases (39.5%), the interobserver agreement was high (Kappa = 1, P <0.01). The CTSI score of two observers was grade Ⅰ in 6 cases (15.8%), grade Ⅱ in 22 cases (57.9%) and grade Ⅲ in 10 cases (26.3% (Kappa = 0.748, 95% CI 0.000 ~ 0.076, P <0.01). The MCTSI scores of two observers were grade Ⅰ in 2 cases (5.3%), grade Ⅱ in 19 cases (50.0%), There were 17 cases (44.7%) with good interobserver agreement (Kappa = 0.788, 95% CI0.000 ~ 0.076, P <0.01). There was a positive correlation between CTSI score and BISAP score (rs = 0.385, P = 0.001). There was also a positive correlation between MCISI and BISAP score (rs = 0.326, P = 0.004). Conclusion Both CT, CTSI and MCTSI score positively correlated with BISAP score, but the correlation was weak.