Wu Dong, Lu Bo, Yang Hong, Li Jingnan, Qian Jiaming
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China. Email:
Zhonghua Nei Ke Za Zhi. 2014 Dec;53(12):937-40.
To evaluate the clinical value of the three-category classification of severe acute pancreatitis (SAP).
Clinical data of 337 traditional SAP patients, who were admitted to Peking Union Medical College Hospital (PUMCH) from January 2001 to December 2012, were retrospectively studied. These patients were classified into moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) according to the latest 2013 Atlanta Classification.SAP patients were further categorized as critical acute pancreatitis (CAP) and non-CAP. Disease severity, therapy and prognosis among three groups were compared.
Among the total 337 traditional SAP patients, 253 were classified as MSAP and 84 as SAP. In the group of SAP, 40 patients were categorized as CAP and 44 as non-CAP. Compared with non-CAP patients, CAP patients had significantly higher mortality rate which was 70% (28/40). Other results were all significantly higher in CAP group rather than non-CAP group, including ICU admission rate 77.5% (31/40), length of ICU stay (15.5 ± 20.6) days, Ranson, APACHE II, BISAP, MCTSI, modified Marshall scores 4.6 ± 1.4, 16.8 ± 5.8, 3.0 ± 1.0, 8.6 ± 1.7, and 7.4 ± 2.9, respectively (P < 0.01 in each endpoint). These parameters of SAP group were also significantly higher than those of MSAP group (P < 0.01).
Using the new three-category classification to distinguish traditional severe acute pancreatitis, namely MSAP, SAP, and CAP, can better reflect the severity of disease, predict outcome and guide clinical management.
评估重症急性胰腺炎（SAP）三类分类法的临床价值。
回顾性研究2001年1月至2012年12月在北京协和医院（PUMCH）收治的337例传统SAP患者的临床资料。根据最新的2013年亚特兰大分类法，将这些患者分为中度重症急性胰腺炎（MSAP）和重症急性胰腺炎（SAP）。SAP患者进一步分为危重症急性胰腺炎（CAP）和非CAP。比较三组患者的疾病严重程度、治疗情况及预后。
在337例传统SAP患者中，253例被分类为MSAP，84例为SAP。在SAP组中，40例患者被分类为CAP，44例为非CAP。与非CAP患者相比，CAP患者的死亡率显著更高，为70%（28/40）。CAP组的其他结果均显著高于非CAP组，包括ICU入住率77.5%（31/40）、ICU住院时间（15.5±20.6）天、Ranson评分、APACHE II评分、BISAP评分、MCTSI评分、改良Marshall评分，分别为4.6±1.4、16.8±5.8、3.0±1.0、8.6±1.7和7.4±2.9（各终点P<0.01）。SAP组的这些参数也显著高于MSAP组（P<0.01）。
采用新的三类分类法区分传统的重症急性胰腺炎，即MSAP、SAP和CAP，能够更好地反映疾病严重程度、预测预后并指导临床管理。
