摘要目的 研究英国国家早期预警评分(NEWS)对急性胰腺炎严重程度和预后的评估价值.方法 回顾性分析2016年3—11月110例急性胰腺炎患者的临床资料.分别计算NWES、Rason评分和急性生理学和慢性健康状况Ⅱ评分(APACHEⅡ评分),应用Pearson线性回归进行相关性分析,并进行受试者工作特征(ROC)曲线分析.结果 110例急性胰腺炎患者中,轻症84例,中重症8例,重症18例.治愈103例;死亡7例,其中中重症1例,重症6例,病死率为6.36%(7/110). NEWS(2.75 ± 2.47)分,轻症(1.92 ± 1.86)分,中重症(4.25 ± 1.58)分,重症(5.94 ± 2.43)分,三者间比较差异有统计学意义(P＜0.05).NEWS与Rason评分和APACHEⅡ评分呈正相关(r=0.653和0.794,P＜0.05).NEWS预测中重症和重症的曲线下面积(AUC)为0.866,临界值为3分,敏感度和特异度分别为77.8%和79.5%;NEWS预测死亡的AUC为0.872,临界值为5分,敏感度和特异度分别为71.4%和89.3%.结论 NEWS可以早期预测急性胰腺炎的严重程度及预后.

abstractsObjective To explore the value of national early warning score (NEWS) to assess the severity and prognosis of acute pancreatitis. Methods The clinical data of 110 patients with acute pancreatitis from March to November 2016 were retrospectively analyzed. The NWES, Rason score and acute physiology and chronic health evaluation Ⅱ score (APACHE Ⅱ score) were calculated respectively. Correlation analysis was carried out with Pearson linear regression, and the receiver operating characteristic (ROC) curve was analyzed. Results Of the 110 patients with acute pancreatitis, the mild was in 84 cases, moderately severe in 8 cases, and severe in 18 cases. One hundred and three cases were cured; 7 cases died, including 1 moderately severe case and 6 severe cases, and the mortality rate was 6.36% (7/110). The NEWS was (2.75 ± 2.47) scores. The NEWS scores of mild cases, moderately severe cases and severe cases were (1.92 ± 1.86) scores, (4.25 ± 1.58) scores, and (5.94 ± 2.43) scores, and there was statistical difference (P＜0.05). NEWS was positively correlated with Rason score and APACHE Ⅱ score (r = 0.653 and 0.794, P＜0.05). The area under curve (AUC) of NEWS predicting moderately severe and severe cases was 0.866. The cut off was 3 scores, and the sensitivity and specificity were 77.8% and 79.5%; the AUC of NEWS predicting death was 0.872. The cut off was 5 scores, and the sensitivity and specificity were 71.4% and 89.3% . Conclusions NEWS score can early predict the severity and prognosis of acute pancreatitis.