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重症急性胰腺炎评分系统开发及超声引导导管引流在高危患者中的应用

Development of a Scoring System For Severe Acute Pancreatitis And Utility of US-guided Catheter Drainage in High-risk Patients.
PubMed 文献 · Acad Radiol · 2026-05-20

本研究基于469例重症急性胰腺炎患者入院实验室指标，开发了由降钙素原>1.195 ng/ml、红细胞<3.61×10¹²/L、白细胞>20.2×10⁹/L和血小板<149×10⁹/L组成的评分系统，≥3分预测死亡的AUC为0.965。在高危患者中，超声引导下经皮导管引流组死亡率显著低于保守组（20.6% vs 57.1%），且发病两周内引流优于延迟干预。

要点

  • 评分≥3分提示重症急性胰腺炎死亡高危，AUC 0.965。
  • 高危患者超声引导PCD较保守治疗显著降低死亡率。
  • 发病两周内行PCD死亡率低于延迟干预。

局限性

  • 回顾性研究设计。
  • 单中心来源可能影响推广。

以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。

英文原文（摘要）· 点击展开

RATIONALE AND OBJECTIVES: Severe acute pancreatitis (SAP) carries a high mortality rate. This study aimed to develop a rapid scoring system using admission laboratory parameters to predict mortality in SAP and to evaluate whether high-risk patients identified by this score benefit from ultrasound-guided percutaneous catheter drainage (PCD).

MATERIALS AND METHODS: In this retrospective study, 469 SAP patients (304 conservative, 165 PCD) from January 2015 to March 2023 were included. After propensity score matching for age, sex, and etiology, 316 well-balanced patients (158 per group) were analyzed. A scoring system was developed from the conservative cohort using multivariate logistic regression, with mortality as the primary outcome.

RESULTS: A scoring system was created comprising procalcitonin >1.195 ng/ml (1 point), RBC <3.61×10¹²/L (1 point), WBC >20.2×10⁹/L (2 points), and platelet <149×10⁹/L (1 point). A cutoff of ≥3 points predicted mortality with an AUC of 0.965. Among high-risk patients (score≥3), mortality was significantly lower in the PCD group than in the conservative group (20.6% vs. 57.1%, p=0.006). Furthermore, PCD performed within two weeks of onset was associated with lower mortality than later intervention (9.5% vs. 22.2%, p=0.026).

CONCLUSION: The proposed scoring system effectively identifies high-risk SAP patients who may obtain a substantial survival benefit from early PCD intervention.

来源：Acad Radiol，查看原文。版权归原作者所有。

引用

  1. Long H, Lin J, Zheng R, et al. Development of a Scoring System For Severe Acute Pancreatitis And Utility of US-guided Catheter Drainage in High-risk Patients. Acad Radiol. 2026. PMID: 42161741. doi:10.1016/j.acra.2026.04.027
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