腹部CT扫描定量腹腔积液对重症急性胰腺炎的预测
Value of peritoneal effusion quantitatively measured by abdominal computed tomography in predicting severe acute pancreatitis
宋志敏 1崔久法 2朱青云 3胡斌 2潘新亭1
作者信息
- 1. 青岛大学附属医院急诊重症监护室,山东青岛 266003
- 2. 青岛大学附属医院放射科,山东青岛 266003
- 3. 青岛大学附属医院超声科,山东青岛 266003
- 折叠
摘要
目的 评估定量腹腔积液预测急性胰腺炎(AP)严重程度的可靠性.方法 收集2018-2021年我院收治的273例AP病人,评估病人腹腔积液的发生情况并定量计算腹腔积液.收集病人的床旁急性胰腺炎严重程度指数(BISAP)评分、急性生理与慢性健康评估Ⅱ(APACHE Ⅱ)评分、CT严重程度指数(CTSI).采用受试者工作特征曲线下面积(AUC)分析腹腔积液量及不同评分系统对AP严重程度的早期预测价值.结果 273例AP病人的腹腔积液发生率为23％.腹腔积液量与AP严重程度(x2=35.88～156.21,P＜0.001)及器官衰竭(t=5.00～12.14,P＜0.001)有关,与各评分系统之间存在正相关(r=0.546～0.716,P＜0.001).腹腔积液量预测重症急性胰腺炎(SAP)的AUC、灵敏度、特异度分别为0.918、87.5％、94.0％;预测器官衰竭的AUC、灵敏度、特异度分别为0.815、70.8％、88.0％.腹腔积液量预测 SAP 的 AUC 高于 BISAP 评分、APACHE Ⅱ 评分(Z=2.101、3.159,P＜0.05).结论 腹腔积液量与AP严重程度相关,与临床评分系统呈正相关,定量腹腔积液可用于早期预测SAP及器官衰竭的发生,且预测SAP的效能高于临床评分系统.
Abstract
Objective To investigate the reliability of quantitative measurement of peritoneal effusion in predicting the se-verity of acute pancreatitis(AP).Methods A total of 273 patients with AP who were admitted to our hospital from 2018 to 2021 were enrolled to evaluate the onset of intra-abdominal fluid and quantitatively calculate the amount of peritoneal effusion.Re-lated data were collected,including Bedside Index for Severity in Acute Pancreatitis(BISAP)score,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,and Computed Tomography Severity Index(CTSI).The receiver operating characte-ristic(ROC)curve and the area under the ROC curve(AUC)were used to investigate the value of peritoneal effusion volume and different scoring systems in the early prediction of the severity of AP.Results The incidence rate of peritoneal effusion was 23％among the 273 AP patients.Peritoneal effusion volume was associated with the severity of AP(x2=35.88-156.21,P＜0.001)and organ failure(t=5.00-12.14,P＜0.001)and was positively correlated with various scoring systems(r=0.546-0.716,P＜0.001).Peritoneal effusion volume had an AUC of 0.918,a sensitivity of 87.5％,and a specificity of 94.0％in predicting severe acute pancreatitis(SAP)and an AUC of 0.815,a sensitivity of 70.8％,and a specificity of 88.0％in predicting organ failure.Peri-toneal effusion volume had a significantly larger AUC than BISAP score and APACHE Ⅱ score in predicting SAP(Z=2.101,3.159;P＜0.05).Conclusion Peritoneal effusion volume is associated with the severity of AP and is positively correlated with clinical scoring systems.Quantitative measurement of peritoneal effusion can be used to predict the onset of SAP and organ failure in the early stage,with a better efficacy than clinical scoring systems in predicting SAP.
关键词
胰腺炎/腹水/体层摄影术,X线计算机/器官衰竭/预测Key words
pancreatitis/ascites/tomography,X-ray computed/organ failure/forecasting引用本文复制引用
基金项目
国家自然科学基金面上项目(81870440)
出版年
2024
国家科技期刊平台
NSTL
万方数据