目的与急性胰腺炎(acute pancreatitis,AP)传统评分系统进行比较,探讨急性胰腺炎严重程度床边指数(bedside index for severity in acute pancreatitis,BISAP)评分对疾病程度及预后的预测价值。方法 202例AP患者分别行BISAP、急性生理和慢性健康状况评分(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)及Ranson评分,比较分析3种评分系统预测AP严重程度、局部并发症、器官功能衰竭的价值。结果 202例AP患者,轻症急性胰腺炎(mild acute pancreatitis,MAP)103例,重症急性胰腺炎(severe acute pancreatitis,SAP)99例;SAP患者发生局部并发症62例,器官功能衰竭60例,23例二类并发症均存在;BISAP评分预测SAP的AUC为0.881(95%CI:0.836~0.927),最佳cutoff值为2,其预测SAP敏感性、特异性、阳性预测值及阴性预测值分别为88.89%、71.84%、75.21%和87.06%;预测SAP患者局部并发症的AUC为0.715(95%CI:0.644~0.785),最佳cutoff值为3,预测SAP局部并发症的敏感性、特异性、阳性预测值及阴性预测值分别为77.42%、75.00%、57.83%和88.24%;预测SAP患者器官功能衰竭的AUC为0.884(95%CI:0.837~0.931),最佳cutoff值为3,预测SAP患者器官功能衰竭的敏感性、特异性、阳性预测值及阴性预测值分别为76.67%、85.21%、68.66%和89.63%。BISAP评分预测AP严重程度、局部并发症、器官功能衰竭的能力与APACHEⅡ和Ranson评分比较差异无统计学意义(P>0.05)。结论 BISAP评分对AP严重程度及预后预测价值与传统评分相同,但构成简单,主观偏倚小,可动态监测变化。 Objective To compare the traditional score system of acute pancreatitis (AP) and evaluate the predictive value of bedside index for severity in acute pancreatitis (BISAP) on disease severity and prognosis. Methods A total of 202 AP patients were evaluated with BISAP, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and Ranson score respectively. The values ​​of AP severity, local complications and organ failure were compared and analyzed by three scoring systems. . Results There were 103 cases of mild acute pancreatitis (MAP) and 99 cases of severe acute pancreatitis (SAP) in 202 AP patients. There were 62 cases of SAP, 60 cases of organ failure, 23 cases of type II complications were present; BISAP score predicts SAP AUC of 0.881 (95% CI: 0.836 ~ 0.927), the best cutoff value of 2, which predicts SAP sensitivity, specificity, positive predictive value and negative predictive value (AUC) were 88.89%, 71.84%, 75.21% and 87.06% respectively. The AUC of predicting the local complications of SAP were 0.715 (95% CI: 0.644-0.785), the best cutoff was 3, Specificity, positive predictive value and negative predictive value were 77.42%, 75.00%, 57.83% and 88.24% respectively. The AUC of predicting organ failure in patients with SAP was 0.884 (95% CI: 0.837-0.931) and the best cutoff was 3 The sensitivity, specificity, positive predictive value and negative predictive value of predicting organ failure in SAP patients were 76.67%, 85.21%, 68.66% and 89.63%, respectively. There was no significant difference between BISAP score and APACHEⅡand Ranson score in predicting AP severity, local complications and organ failure (P> 0.05). Conclusion The BISAP score has the same predictive value of AP severity and prognosis as the traditional score, but with simple constitution and small subjective bias, it can dynamically monitor the changes.