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目的分析第四代急性生理与慢性健康评分系统(APACHE-Ⅳ)在重症急性胰腺炎中的应用价值,对APACHE-Ⅳ评分系统在中国人群中的适用性做出判断。方法回顾性分析2012年1月-2017年1月在包头市中心医院普外科确诊为重症急性胰腺炎55例患者资料,均完成APACHE-Ⅱ评分和APACHE-Ⅳ评分,应用ROC曲线下面积(AUC)检验APACHE-Ⅳ评分系统对急性胰腺炎预后的预测价值。结果 APACHE-Ⅳ评分与机械通气、血液净化、入住ICU、全身炎性反应综合征(SIRS)、器官衰竭、住院天数、病死有相关性。通过分析AUC值,APACHE-Ⅳ评分系统对预测SAP、器官功能衰竭及病死均具有较好的预测效果,其中对SIRS和器官功能衰竭的预测价值高于APACHEⅡ评分。结论 APACHE-Ⅳ可用于预测急性胰腺炎的预后,评分的高低与急性胰腺炎严重程度及预后密切相关,评分越高,发生器官功能衰竭甚至病死的可能性越大。
Objective To analyze the value of APACHE-Ⅳ in severe acute pancreatitis and to evaluate the applicability of APACHE-Ⅳ scoring system in Chinese population. Methods The data of APACHE-Ⅱ and APACHE-Ⅳ in 55 patients diagnosed as severe acute pancreatitis from January 2012 to January 2017 in Department of General Surgery, Baotou Central Hospital were retrospectively analyzed. The area under the curve of ROC (AUC ) Test APACHE-Ⅳ score system for the prediction of the prognosis of acute pancreatitis. Results APACHE-Ⅳ score was correlated with mechanical ventilation, blood purification, ICU admission, systemic inflammatory response syndrome (SIRS), organ failure, length of hospital stay, and death. By analyzing the AUC, the APACHE-IV scoring system has good predictive value for the prediction of SAP, organ failure and disease death, and the prediction value of SACH and organ failure is higher than APACHEⅡscore. Conclusion APACHE-Ⅳ can be used to predict the prognosis of acute pancreatitis. The score is closely related to the severity and prognosis of acute pancreatitis. The higher the score, the greater the possibility of organ failure or even death.