新日本严重度评分评估重症急性胰腺炎严重度及风险的价值

目的 研究新日本严重度评分(JSS)对重症急性胰腺炎(SAP)严重度及风险的评估价值.方法 回顾性分析SAP患者临床资料,运用新JSS评分对患者预后、多脏器功能障碍综合征(MODS)的发生率及中转手术发生率进行预测,并与APACHEⅡ评分、Ranson评分和Balthazar CT分级(CTSI)评分进行比较.结果 以新JSS评分预测SAP患者预后、MODS发生率及中转手术发生率的受试者工作特征曲线下面积(AUCROC)分别为0.88、0.91和0.74(P ＜0.01),灵敏度分别为100％、95.50％和97.10％,特异度分别为69.60％、75.80％和46.90％.综合各项指标,新JSS评分在预测SAP患者预后和MODS发生率方面优于其他评分系统.新JSS评分还可预测中转手术次数,分值随手术次数的增多而升高(P＜0.05).结论 新JSS评分在预测SAP患者预后、MODS发生率及手术次数方面具有优势,但目前尚无法用单一的评分系统对疾病的预后和严重程度加以判断.

Value of new Japanese severity score in assessment of severity and risk of severe acute pancreatitis

Objective To investigate the value of new Japanese severity score in the assessment of severity and risk of severe acute pancreatitis(SAP).Methods The clinical data of patients with SAP were retrospectively analysed.New JSS was employed to predict the outcomes,prevalence of multiple organ dysfunction syndrome(MODS) and prevalence of transfer operation,and the results were compared with findings from acute physiology and chronic health evaluationⅡ(APACHEⅡ) score,Ranson score and Balthazar computed tomography severity index(CTSI) score.Results The areas under the receiver operating characteristic curve(AUCROC) were 0.88,0.91 and 0.74 respectively(P<0.01),the values of sensitivity were 100%,95.50% and 97.10% respectively,and the values of specificity were 69.60%,75.80% and 46.90% respectively for new JSS in assessment of outcomes,prevalence of MODS and prevalence of transfer operation in patients with SAP.New JSS worked better than the other scoring systems in prediction of outcomes and prevalence of MODS in patients with SAP.In addition,new JSS could be used to assess the times of transfer operation,and the scores increased with the times of operation(P<0.05).Conclusion New JSS performs better in assessment of outcomes,prevalence of MODS and times of operation in patients with SAP.However,the outcomes and severity of SAP can not be evaluated with just one scoring system.