Zerem Dina, Zerem Omar, Zerem Enver
Medical Faculty, University of Tuzla, 75000 Tuzla, Bosnia and Herzegovina.
Department of Medical Sciences, The Academy of Sciences and Arts of Bosnia and Herzegovina, 71000 Sarajevo, Bosnia and Herzegovina.
Euroasian J Hepatogastroenterol. 2017 Jan-Jun;7(1):1-5. doi: 10.5005/jp-journals-10018-1202. Epub 2017 May 5.
The assessment of the severity of acute pancreatitis (AP) is important for proper management of the disease and for its prognosis. The aim was to correlate clinical, biochemical, and imaging diagnostic parameters and evaluate their prognostic values in the early assessment of severity of AP.
We prospectively studied 128 consecutive patients with AP. The predictors were clinical, biochemical, and imaging diagnostic parameters. The outcome measure was the occurrence of complications. Abdominal sonogram, contrast-enhanced computer tomography, and pancreatitis-specific clinical and laboratory findings were done.
According to the Atlanta classification, 84 patients (65.6%) had mild and 44 (34.4%) had severe AP. The severity markers were significantly different between the mild and the severe groups (p < 0.001). Leukocyte count, serum albumin level, C-reactive protein (CRP), Ranson, acute physiology and chronic health evaluation II (APACHE II), and Glasgow score were the factors associated with radiological severity grade. Leukocyte count, CRP, Ranson score, APACHE II, and Glasgow score were the factors associated with the number and appearance of acute fluid collections (AFCs). A significant association was found between the number of AFCs and the occurrence of complications [odds ratio 4.4; 95% confidence interval 2.5-7.6]. Hospital stay was significantly longer in the group with severe disease as compared with the group with mild disease (p < 0.001).
Clinical, biochemical, and imaging diagnostic parameters are related to the clinical course of AP and they can predict its severity. This allows us to determine the severity of the disease and to target the patients with high scores for close monitoring and more aggressive intervention. Zerem D, Zerem O, Zerem E. Role of Clinical, Biochemical, and Imaging Parameters in predicting the Severity of Acute Pancreatitis. Euroasian J Hepato-Gastroenterol 2017;7(1):1-5.
评估急性胰腺炎（AP）的严重程度对于该疾病的合理管理及其预后至关重要。本研究旨在关联临床、生化及影像学诊断参数，并评估它们在AP严重程度早期评估中的预后价值。
我们对128例连续的AP患者进行了前瞻性研究。预测指标为临床、生化及影像学诊断参数。观察指标为并发症的发生情况。进行了腹部超声、增强计算机断层扫描以及胰腺炎特异性临床和实验室检查。
根据亚特兰大分类，84例患者（65.6%）为轻度AP，44例（34.4%）为重度AP。轻度和重度组之间的严重程度标志物存在显著差异（p < 0.001）。白细胞计数、血清白蛋白水平、C反应蛋白（CRP）、兰森评分、急性生理与慢性健康状况评估II（APACHE II）以及格拉斯哥评分是与放射学严重程度分级相关的因素。白细胞计数、CRP、兰森评分、APACHE II以及格拉斯哥评分是与急性液体积聚（AFC）的数量和表现相关的因素。AFC的数量与并发症的发生之间存在显著关联[比值比4.4；95%置信区间2.5 - 7.6]。与轻度疾病组相比，重度疾病组的住院时间显著更长（p < 0.001）。
临床、生化及影像学诊断参数与AP的临床病程相关，并且能够预测其严重程度。这使我们能够确定疾病的严重程度，并针对高分患者进行密切监测和更积极的干预。泽雷姆D、泽雷姆O、泽雷姆E。临床、生化及影像学参数在预测急性胰腺炎严重程度中的作用。《欧亚肝脏胃肠病学杂志》2017；7(1):1 - 5。
