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Ranson评分对中重度高脂血症性急性胰腺炎分型的预测价值

齐衍濛 刘业成 朱华栋

齐衍濛, 刘业成, 朱华栋. Ranson评分对中重度高脂血症性急性胰腺炎分型的预测价值[J]. 协和医学杂志, 2019, 10(5): 489-493. doi: 10.3969/j.issn.1674-9081.2019.05.011
引用本文: 齐衍濛, 刘业成, 朱华栋. Ranson评分对中重度高脂血症性急性胰腺炎分型的预测价值[J]. 协和医学杂志, 2019, 10(5): 489-493. doi: 10.3969/j.issn.1674-9081.2019.05.011
Yan-meng QI, Ye-cheng LIU, Hua-dong ZHU. Predictive Value of Ranson Score for Typing Moderately Severe and Severe Hyperlipidemic Acute Pancreatitis[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(5): 489-493. doi: 10.3969/j.issn.1674-9081.2019.05.011
Citation: Yan-meng QI, Ye-cheng LIU, Hua-dong ZHU. Predictive Value of Ranson Score for Typing Moderately Severe and Severe Hyperlipidemic Acute Pancreatitis[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(5): 489-493. doi: 10.3969/j.issn.1674-9081.2019.05.011

Ranson评分对中重度高脂血症性急性胰腺炎分型的预测价值

doi: 10.3969/j.issn.1674-9081.2019.05.011
详细信息
    通讯作者:

    刘业成 电话:010-69159100, E-mail:ptcaliu@sina.com

  • 中图分类号: R657.5+1

Predictive Value of Ranson Score for Typing Moderately Severe and Severe Hyperlipidemic Acute Pancreatitis

More Information
    Corresponding author: LIU Ye-cheng Tel: 86-10-69159100, E-mail:ptcaliu@sina.com
  • 摘要:   目的  探讨Ranson评分对高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis, HLAP)分型的早期预测价值。  方法  回顾性收集2014年1月至2018年10月在北京协和医院急诊科就诊的中重度HLAP患者资料, 包括年龄、性别、血脂水平、血糖、白细胞、乳酸脱氢酶(lactate dehydrogenase, LDH)、谷草转氨酶(aspartate aminotransferase, AST)以及入院48 h后的血细胞比容、尿素氮、血钙、碱缺乏、液体丢失量。按照疾病严重程度分为中度和重度HLAP, 并计算每例患者的Ranson评分。采用t检验比较中度和重度HLAP组间Ranson评分的差异, 运用受试者工作特征(receiver operating characteristic, ROC)曲线分析得出最佳界值, 计算其敏感度和特异度, 以卡方检验验证其一致性。  结果  共计99例符合入选和排除标准的HLAP患者进入本研究, 其中中、重度HLAP分别为45例和54例。重度HLAP组的Ranson评分显著高于中度组, 差异具有统计学意义(5.19±1.33比3.09±1.35, P < 0.01)。ROC曲线分析显示4为最佳临界值, 敏感度为75.9%, 特异度为84.4%;以4为临界值, Ranson评分3~4者符合中度HLAP的表现, Ranson评分 > 4符合重度HLAP表现, 中度和重度组的Ranson评分与疾病分型一致(P < 0.01)。  结论  Ranson评分可用于中度和重度HLAP分型早期预测, 3~4分提示中度HLAP, > 4分提示重度HLAP。
    利益冲突  无
  • 图  1  Ranson评分用于评估中度和重度高脂血症性急性胰腺炎的曲线下面积

    表  1  中度和重度HLAP患者的一般临床资料比较

    指标 中度HLAP(n=45) 重度HLAP(n=54)
    年龄(x±s, 岁) 40.2±14.6 42.6±11.5
    性别(n)
      女 25 29
      男 20 25
    血脂最高水平(mmol/L) >70 >70
    白细胞计数>16×109/L [n(%)] 17(37.8) 33(61.1)
    血糖>11 mmol/L [n(%)] 22(48.9) 37(68.5)
    LDH>350 U/L [n(%)] 11(24.4) 27(50.0)
    Hct下降>10% [n(%)] 19(42.2) 31(57.4)
    血钙<2 mmol/L [n(%)] 17(37.8) 46(85.2)
    碱缺乏>6 mmol/L [n(%)] 10(22.2) 27(50.0)
    液体需要量>6 L[n(%)] 16(35.6) 43(79.6)
    Ranson评分(x±s) 3.09±1.35 5.19±1.33
    HLAP:高脂血症性急性胰腺炎;LDH:乳酸脱氢酶;Hct:血细胞比容
    下载: 导出CSV

    表  2  中度和重度HLAP患者的Ranson评分结果

    Ranson评分 中度HLAP(n) 重度HLAP(n)
    >4分 7 41
    3~4分 38 13
    P <0.01 <0.01
    HLAP:同表 1
    下载: 导出CSV
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出版历程
  • 收稿日期:  2018-11-29
  • 刊出日期:  2019-09-30

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