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目的:探讨序贯器官衰竭评估(SOFA)评分、急性生理与慢性健康评估Ⅱ(APACHEⅡ)评分和腹部CT胰腺外炎症(EPIC)评分对预测重症急性胰腺炎(SAP)并发胰腺感染的意义。方法:选取127例SAP病人进行研究,入院24 h内对病人进行SOFA、APACHEⅡ和EPIC评分,分析三种评分方法对预测病人病情的价值。结果:感染组病人三种评分均高于非感染组,且差异均有显著性统计学意义(P<0.05)。在已并发胰腺感染的SAP病人中,发现APACHEⅡ评分、SOFA评分和EPIC评分的AUC数值依次为0.787、0.786、0.765,说明三种评分在感染预后的评估中具有一定的价值。EPIC评分和APACHEⅡ评分的灵敏度相等,均高于SOFA评分;APACHEⅡ评分和SOFA评分的特异性均高于EPIC评分。将三种评分做Logstic回归分析显示,EPIC评分对SAP并发胰腺感染有预测价值(P<0.05)。结论:三种评分法对SAP病人的感染预后评估有一定的价值。EPIC评分为SAP并发胰腺感染的危险因素,具有预测作用,可帮助临床早期采取必要的临床干预。
Objective: To investigate the significance of predicting the severity of pancreatic infection in patients with severe acute pancreatitis (SAP) by using sequential organ failure assessment (SOFA) score, acute physiology and chronic health assessment Ⅱ (APACHE Ⅱ) score and abdominal CT pancreas exacerbation (EPIC) score. Methods: A total of 127 patients with SAP were enrolled in this study. SOFA, APACHEⅡand EPIC were scored in patients within 24 hours after admission, and the value of the three scoring methods in predicting patient’s condition was analyzed. Results: The three scores of patients in infection group were higher than those in non-infected group, and the differences were statistically significant (P <0.05). In patients with SAP complicated with pancreatic infection, the AUC values of APACHEⅡ, SOFA and EPIC were found to be 0.787, 0.786 and 0.765, respectively, indicating that the three scores have some value in the assessment of prognosis. EPIC score and APACHE Ⅱ score equal sensitivity, were higher than the SOFA score; APACHE Ⅱ score and SOFA score were higher than the specificity of the EPIC score. Logistic regression analysis of the three scores showed that the EPIC score had a predictive value for SAP complicated with pancreatic infection (P <0.05). Conclusion: The three scoring methods have some value in evaluating the prognosis of patients with SAP infection. The EPIC score is a risk factor for SAP complicated with pancreatic infection, which has a predictive value and can help clinical take the necessary clinical intervention early.