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目的探讨Ranson评分与Glasgow评分对急性胰腺炎(acute pancreatitis,AP)疾病严重程度及预后预测价值的差异。方法回顾性地收集自2014年7月至2016年7月230例AP病人的临床资料,结合中国胰腺炎诊治指南(2007)将病人分为轻症胰腺炎(mild acute pancreatitis,MAP)组、重症胰腺炎(severe acute pancreatitis,SAP)组。按照各评分系统相应评分标准对病人进行Ranson评分和Glasgow评分。比较组间病人一般临床资料及Ranson评分、Glasgow评分的差异,ROC曲线比较两评分系统对AP疾病严重程度及预后预测价值的差异。结果 MAP组与SAP组病人一般情况相比差异无统计学意义(P均>0.05),而SAP组病人Ranson评分、Glasgow评分结果相对较高,与MAP组相比差异有统计学意义(P均<0.05)。Ranson评分预测SAP的敏感性和特异性分别为61.16%和66.52%,Glasgow评分预测SAP的敏感性和特异性分别为44.40%和77.32%,两者预测SAP的曲线下面积(AUC)分别为0.69和0.67,组间差异无统计学意义(P>0.05);Ranson评分预测AP病人住院期间死亡的敏感性和特异性分别为75.00%和63.55%、Glasgow洋分预测AP病人住院期间死亡的敏感性和特异性分别为62.53%和75.26%,而两者预测AP病人住院期间死亡的AUC分别为0.85和0.66,组间差异有统计学意义(P<0.05)。结论Ranson评分在AP病人疾病严重程度和预后判断方面较Glasgow评分具有更高的稳定性和可信度,值得临床进一步研究证实。
Objective To explore the difference between Ranson score and Glasgow score on the severity of acute pancreatitis (AP) and its prognostic value. Methods The clinical data of 230 AP patients from July 2014 to July 2016 were retrospectively collected. Patients were divided into mild acute pancreatitis (MAP) group, severe type Severe acute pancreatitis (SAP) group. Patients were scored Ranson and Glasgow according to the corresponding grading system of each grading system. Compare the general clinical data of patients and Ranson score, Glasgow score differences, ROC curve comparison of the two scoring system on the severity of AP disease and the prognosis of the difference in value. Results There was no significant difference between MAP group and SAP group (P> 0.05), while the Ranson score and Glasgow score of SAP group were higher than those of SAP group (P <0.05) <0.05). The sensitivity and specificity of Ranson score prediction for SAP were 61.16% and 66.52% respectively. The sensitivity and specificity of Glasgow score for prediction of SAP were 44.40% and 77.32% respectively. The predicted area under the curve (AUC) of SAP was 0.69 And 0.67, respectively. There was no significant difference between the two groups (P> 0.05). The sensitivity and specificity of Ranson score in predicting AP death during hospitalization were 75.00% and 63.55%, respectively. And specificity were 62.53% and 75.26%, respectively. However, the predicted AUC of both deaths of AP patients during hospitalization were 0.85 and 0.66, respectively. The differences between the two groups were statistically significant (P <0.05). Conclusion The Ranson score has a higher stability and reliability than the Glasgow score in the severity and prognosis of AP patients, which is worth further clinical confirmation.