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目的通过观察重症急性胰腺炎(severe acute pancreatitis,SAP)的多排螺旋CT(MDCT)表现,总结分析其CT特征,探讨多种CT评分与SAP合并急性肾损伤(acute kidney injury,AKI)的相关性。方法回顾性分析我院2008年3月至2010年12月收治的经临床确诊的SAP患者119例,并进行相关CT评分〔包括BalthazarCT分级、CT严重指数(CTSI)评分及腹部CT胰腺外炎症(EPIC)评分〕;同时总结SAP患者临床资料,包括尿量、血肌酐及预后,总结CT评分与临床表现的相关性。结果 SAP合并AKI患者常合并多脏器功能障碍(88.1%),死亡率高(47.6%),SAP合并AKI患者的CT评分分值均高于未合并AKI的SAP患者。在CT评分中,EPIC评分预测AKI的准确性较好〔ROC曲线下面积(AUC)为0.903〕,优于传统的CTSI评分(AUC为0.721)及BalthazarCT分级(AUC为0.571)。结论各项CT评分中,EPIC评分预测SAP合并AKI的准确性优于CTSI评分及Balthazar CT分级,并与AKI的发生具有良好的相关性。
Objective To observe the CT features of multiple acute pancreatitis (SAP) by observing the multi-detector row spiral CT (MDCT) of severe acute pancreatitis (SAP), and to explore the correlation between various CT scores and acute kidney injury (AKI) Sex. Methods A retrospective analysis of 119 patients with clinically diagnosed SAP admitted to our hospital from March 2008 to December 2010 was performed and related CT scores (including Balthazar CT grade, CT severity index (CTSI) score and abdominal CT pancreas inflammation EPIC) score]; at the same time summarize the clinical data of patients with SAP, including urine output, serum creatinine and prognosis, summarizes the correlation between CT score and clinical manifestations. Results Patients with SAP and AKI often had multiple organ dysfunction (88.1%) with high mortality (47.6%). The scores of CT scores in SAP patients with AKI were significantly higher than those without SAP. Among CT scoring, EPIC score predicted AKI better (AUC 0.903) than traditional CTSI score (AUC 0.721) and Balthazar CT grade (AUC 0.571). Conclusion The accuracy of EPIC score predicting SAP with AKI is superior to CTSI score and Balthazar CT classification in all CT scoring and has a good correlation with the occurrence of AKI.