摘要目的 评估急性生理和慢性健康状况Ⅱ评分(APACHE-Ⅱ评分)及腹部CT胰外炎症评分(EPIC评分)对急性胰腺炎(AP)预后的预测价值.方法 回顾性研究入院24 h内行腹部CT检查和急性生理指标检查的AP患者147例.用受试者工作特征(ROC)曲线分析各评分标准预测重症AP的敏感度、特异度、约登指数及ROC曲线下面积(AUC),分析各评分标准对重症AP的预测能力.结果 147例患者中重症AP 43例.轻症和重症AP患者两种评分差异均有统计学意义(P<0.01). EPIC评分预测重症AP的敏感度0.893,特异度0.870,AUC最大.EPIC评分预测局部并发症的AUC最大,EPIC评分与APACHE-Ⅱ评分预测全身并发症的AUC相当.结论 APACHE-Ⅱ评分与EPIC评分相结合能在入院24h内有效预测AP的预后.

abstractsObjective To assess the value of acute physiology and chronic health evaluationⅡ (APACHE-Ⅱ) score and extrapancreatic inflammation on abdominal computed tomography (EPIC) score in predicting outcome of patients with acute pancreatitis (AP).Methods One hundred and forty-seven patients with AP who underwent abdominal computed tomography scan within 24 h and acute physiological examination after admission were studied.To assess their value in predicting severe AP and complications,the APACHE Ⅱ score and EPIC score was calculated and evaluated by calculating receiver operator characteristic (ROC)curves,the sensitivity,the specificity,the Youden index and the area under the ROC curve (AUC).Results Forty-three of 147 patients developed severe AP.The mean scores of APACHE-Ⅱ score and EPIC score two criteria systems was significantly higher in severe AP than that in mild AP (P< 0.01).EPIC score had 0.893 sensitivity,0.870 specificity and the largest AUC for predicting severe AP.EPIC score had the largest AUC in predicting local complications.But the EPIC score was equal to the APACHE-Ⅱ score in AUC to predict systemic complications.Conclusion In patients with AP.EPIC score and APACHE-Ⅱ score combination will estimate the prognosis of disease accurately within 24 h of admission.