全身炎症反应综合征与急性胰腺炎病情严重程度关系的探讨

目的探讨全身炎症反应综合征(SIRS)与急性胰腺炎病情严重程度的相关关系，为临床治疗SIRS、降低重症急性胰腺炎病死率提供临床依据。方法调查分析2001年1月1日-2003年12月31日入住北京友谊医院感染暨急救医学科并确诊为急性胰腺炎的172例患者，患者按预后分为存活组与死亡组，采用急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分将存活患者又分为重型组与轻型组，对各组患者有无SIRS、符合SIRS诊断标准项目数、SIRS组与非SIRS组间和不同符合诊断标准项目数患者间APACHEⅡ评分进行比较分析。结果存活组与死亡组间有无SIRS及符合SIRS诊断标准项目数差异均有极显著性；存活患者中轻型组与重型组间有无SIRS及符合SIRS诊断标准项目数患者差异也有极显著性。APACHEⅡ评分在SIRS组与非SIRS组间以及不同符合SIRS诊断标准项目数患者间差异有显著性；存活组中轻型组与重型组间SIRS持续时间差异有显著性。结论SIRS与急性胰腺炎病情严重程度密切相关，早期识别及积极有效防治SIRS可提高重症急性胰腺炎治愈率。

Investigation on the relation between systemic inflammatory response syndrome and severity of acute pancreatitis

OBJECTIVE: To explore the relationship between the systemic inflammatory response syndrome (SIRS) and the severity of the acute pancreatitis, so as to provide some leads in the treatment to lower the mortality of severe acute pancreatitis. METHODS: One hundred and seventy-two patients suffering from acute pancreatitis admitted to our departments from January 1, 2001 to December 31, 2003 were retrospectively analyzed. The patients were divided into survivor group and nonsurvivor group, and patients in the survivor group were further divided into severe group and mild group according to scores of acute physiology and chronic health evaluation II (APACHE II). The scores of APACHE II were compared between patients without SIRS and those who met the criteria of SIRS. RESULTS: There was significant difference between the survivor group and nonsurvivor group not only in the incidence of patients who developed SIRS, but also in the number of patients fulfilling or not fulfilling the diagnostic criteria of SIRS between the severe group and mild group. There was also significant statistical difference between the SIRS group and non-SIRS group in the APACHE II scoring. Significant difference in duration of SIRS was found between the severe group and mild group. CONCLUSION: SIRS is highly correlated with the severity of acute pancreatitis. Active prevention and treatment of SIRS may raise the survival rate of severe acute pancreatitis.