重症急性胰腺炎预测的早期相关因素临床分析(1)
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[摘要] 目的 探讨预测急性胰腺炎病情轻重的早期相关因素。方法 428例急性胰腺炎患者按病情轻重分轻症组248例，重症组180例，回顾性分析入院24h内临床和实验室检查资料。 结果 轻症和重症两组患者比较，将有统计学意义的各观察指标经Logistic回归分析，预测急性胰腺炎病情严重度的相关因素依次为血钙>白细胞计数>血清白蛋白>肌酐>心率。血钙下降预测病情严重度最明显。结论 血钙、白细胞计数、血清白蛋白、肌酐、心率可作为预测急性胰腺炎病情严重度相对独立的因素。
[关键词] 急性胰腺炎；相关因素；Logistic回归分析
[中图分类号] R657.51 [文献标识码] B [文章编号] 1673-9701(2011)33-25-03
Clinical Analysis of Early Related Factors for Prediction of Severe Acute Pancreatitis
GAO Huyun1 HU Jianguo2 CHEN Jia1 WANG Pingfan1 YANG Xinye1 ZHANG Yongping1
1.Department of Gastroenterology，Zhejiang Xingchang County People’s Hospital，Xinchang 312500，China；2. Department of Gastroenterology，Affiliated Hospital of Ningxia Medical College，Yinchuan 750004，China
[Abstract] Objective To explore the early prognostic indexes associated with severity of acute pancreatitis. Methods All 428 cases of acute pancreatitis(AP)were divided in two groups，mild acute pancreatitis(MAP) 248 cases and severe acute pancreatitis(SAP)180 cases. Clinical and laboratory’s data within 24 hours after admission of those patients were analyzed retrospectively. Results Within significant different indexes between MAP group and SAP group. blood calcium， blood lencocyte count，blood albumin，creatinine，heart rate were by turns prognostic indexes associated with severity of AP. by Logistic regression analysis，blood calcium alteration(decrease) was the most distinct prognostic index. Conclusion Blood calcium，blood lencocyte count，blood albumin，creatinine，heart rate are by turns prognostic indexes associated with severity of AP. These indexes above are independent prognostic indexes of SAP.
[Key word] Acute pancreatitis；Related factors；Logistic regression
急性胰腺炎(AP)是临床上常见的急症之一。随着人们生活水平的提高及膳食结构的改变，其发病有逐年增加趋势。AP中有20%～30%病情变化发展快，临床经过凶险，死亡率高[1]。因而需要早期判断病情，进而及早施行有针对性的治疗，降低死亡率。重症急性胰腺炎(SAP)过去判断主要依靠临床表现，但评估准确性仅有34%～39%[2]。此后相继有Ranson评分及APACHE-Ⅱ评分等各种方法。但现有的评价方法重复性欠佳、繁琐、不够全面。本研究主要对急性胰腺炎病情严重度预测的早期相关因素做些探讨，以期指导临床。
1 资料与方法
1.1 一般资料
收集我院近10年AP 428例，AP的诊断标准依据2004年中国急性胰腺炎诊治指南(草案)[3]。轻症急性胰腺炎(MAP)评判标准依据2004年中国急性胰腺炎诊治指南(草案)[3]。SAP评判标准依据2009年重症急性胰腺炎内科规范治疗建议 [4] ......
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