重症急性胰腺炎死亡危险因素分析和风险预测模型的初步研究

发布时间：2018-10-26 10:13

【摘要】：目的：分析重症急性胰腺炎(severe acute pancreatitis, SAP)死亡的危险因素和建立危险因素的风险模型。 方法：回顾性分析遵义医学院附属医院2006年1月至2011年12月收治患者269例SAP的临床资料,根据预后分为存活组234人与死亡组35人,采用单因素分析的方法,比较SAP患者一般资料、职业、诱因、病因、生化检验、初发型与复发型及是否手术在存活组和死亡组中的差异。筛选出有统计学差异的自变量,采用多因素Logistic回归的方法,分析SAP独立危险因素,建立危险因素的风险模型,并对风险模型进行评价。 结果：(1)存活组和死亡组年龄、心率、呼吸、血氧饱和度、白细胞、血清淀粉酶、尿素氮、肌酐、第一个24h排便量及排便次数、CTSI评分、APACHE Ⅱ评分(≤48h)、ARDS、SIRS、MODS、胰周包裹性积液、胰性脑病、腹腔间隔室综合征、高血压病史有统计学差异((P＜0.05)。多因素Logistic回归显示ARDS、MODS、尿素氮(BUN)、 APACHE Ⅱ评分是SAP患者死亡的独立危险因素。(2)建立SAP的风险模型,其灵敏度为97.9%,特异度为91.4%,阳性预测值为98.7%,阴性预测值为86.5%；一致性的检验统计量Kappa=0.872,有统计学意义(P＜0.01)；ROC曲线下面积(area under curve, AUC)为0.946。 结论：ARDS、MODS、尿素氮(BUN)和APACHE Ⅱ(≤48h)评分是SAP患者死亡的独立危险因素。该风险预测模型在一定程度上可对SAP患者的预后做出判断。
[Abstract]:Objective: to analyze the risk factors and risk models of (severe acute pancreatitis, SAP) death in severe acute pancreatitis. Methods: the clinical data of 269 patients with SAP in the affiliated Hospital of Zunyi Medical College from January 2006 to December 2011 were retrospectively analyzed. According to the prognosis, the patients were divided into survival group (234 cases) and death group (35 cases). To compare the differences of general data, occupation, inducement, etiology, biochemical test, initial onset and recurrence, and whether or not the operation was performed between the survival group and the death group in SAP patients. The independent variables with statistical difference were screened out and the independent risk factors of SAP were analyzed by multivariate Logistic regression method. The risk model of risk factors was established and the risk model was evaluated. Results: (1) Age, heart rate, respiration, oxygen saturation, white blood cell, serum amylase, urea nitrogen, creatinine, first 24 h defecation volume and defecation times, CTSI score, APACHE 鈪，

本文编号：2295384