摘要
背景 高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)需要早期识别其潜在的致命性并发症,研究已表明急性胰腺炎严重程度床旁指数(bedside index for severity in acute pancreatitis,BISAP)评分与这些并发症相关.目的 通过Meta分析评估BISAP评分对HLAP严重性的预测价值.方法 检索国内外主要数据库,收集BISAP评分预测HLAP严重性的研究,用Stata及Meta-disc软件行Meta分析.结果 本Meta纳入10篇文章(n=1591).BISAP评分≥3分预测HLAP发生死亡的总敏感性、特异性、曲线下面积(area under curve,AUC)、诊断比值比(diagnostic odds ratio,DOR)分别为0.85(95%CI:0.65-0.96)、0.86(95%CI:0.82-0.88)、0.937、42.00(95%CI:12.86-139.12).BISAP评分升高预测HLAP发生重症急性胰腺炎(severe acute pancreatitis,SAP)的总敏感性、特异性、AUC、DOR分别为0.69(95%CI:0.61-0.76)、0.82(95%CI:0.78-0.85)、0.900、18.47(95%CI:6.82-42.03);预测中重症急性胰腺炎(moderately severe acute pancreatitis,MSAP)+SAP的总敏感性、特异性、AUC、DOR分别为0.54(95%CI:0.50-0.63)、0.91(95%CI:0.89-0.93)、0.724、15.55(95%CI:6.91-34.99).BISAP评分与急性生理与慢性健康评分(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、Ranson评分相比,结合自身优点,预测HLAP严重性更具优势.结论 BISAP评分是预测HLAP严重性的有利工具,但预测SAP、MSAP+SAP的敏感性偏低.
BACKGROUND Early identification of hyperlipidemic acute pancreatitis(HLAP) patients at risk of developing potentially lethal complications is of great clinical significance.Studies have suggested that the bedside index for in acute pancreatitis(BISAP) score is associated with adverse outcomes.AIM To assess the accuracy of BISAP score as a prognostic marker for severity of HLAP.METHODS A systematic search of main computerized databases was performed to identify eligible cohort studies on the predictive value of BISAP score for severity of HLAP.The STATA software and Meta-disc software were applied to carry out the meta-analysis.RESULTS Ten studies(n = 1591) were included.The overall sensitivity and specificity of BISAP score ≥ 3 for predicting mortality in HLAP were 0.85(95% confidence interval [CI]:0.65-0.96) and 0.86(95%CI:0.82-0.88),respectively;the area under the curve(AUC) was 0.937,and the diagnostic odds ratio(DOR) was 42.00(95%CI:12.86-139.12).Regarding the increase of BISAP score for prediction of severe acute pancreatitis(SAP),the pooled sensitivity was 0.69(95%CI:0.61-0.76),and the specificity was 0.82(95%CI:0.78-0.85),with AUC and DOR being 0.900 and 18.47(95%CI:6.82-42.03),respectively.The pooled sensitivity,specificity,and DOR for prediction of moderately severe acute pancreatitis(MASP) + SAP were 0.54(95%CI:0.50-0.63),0.91(95%CI:0.89-0.93),and 15.55(95%CI:6.91-34.99),respectively;the AUC was 0.724.BISAP score was superior to APACH Ⅱ and Ranson score in predicting the severity of HLAP.CONCLUSION BISAP score is a reliable tool to identify the severity of HLAP,but it has a suboptimal sensitivity for predicting SAP and SAP + MSAP.
作者
吕永才
姚燕华
吴德彪
雷静静
Yong-Cai Lv;Yan-Hua Yao;De-Biao Wu;Jing-Jing Lei(Department of Gastroenterology,Zhenning Buyi and Miao Autonomous County People’s Hospital,Zhenning 561200,Guizhou Province,China;Department of Ultrasound,Zhenning Buyi and Miao Autonomous County Traditional Chinese Hospital,Zhenning 561200,Guizhou Province,China;Department of Geriatric Medicine,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou Province,China)
出处
《世界华人消化杂志》
CAS
2022年第16期710-717,共8页
World Chinese Journal of Digestology
基金
贵阳市科技局大健康科技合作计划项目,No.[2018]1-72。
