Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea.
Medicina (Kaunas). 2022 Jun 11;58(6):787. doi: 10.3390/medicina58060787.
Acute pancreatitis has a diverse etiology and natural history, and some patients have severe complications with a high risk of mortality. The prediction of the severity of acute pancreatitis should be achieved by a careful ongoing clinical assessment coupled with the use of a multiple-factor scoring system and imaging studies. Over the past 40 years, various scoring systems have been suggested to predict the severity of acute pancreatitis. However, there is no definite and ideal scoring system with a high sensitivity and specificity. The interest in new biological markers and predictive models for identifying severe acute pancreatitis testifies to the continued clinical importance of early severity prediction. Although contrast-enhanced computed tomography (CT) is considered the gold standard for diagnosing pancreatic necrosis, early scanning for the prediction of severity is limited because the full extent of pancreatic necrosis may not develop within the first 48 h of presentation. This article provides an overview of the available scoring systems and biochemical markers for predicting severe acute pancreatitis, with a focus on their characteristics and limitations.
急性胰腺炎病因多样，自然病程各异，部分患者病情严重，并发症多，病死率高。应通过持续的临床评估，并结合多因素评分系统和影像学检查来预测急性胰腺炎的严重程度。在过去的 40 年中，已经提出了多种评分系统来预测急性胰腺炎的严重程度。但是，目前尚无一种具有高灵敏度和特异性的明确和理想的评分系统。人们对用于识别重症急性胰腺炎的新型生物标志物和预测模型的研究兴趣，证明了早期严重程度预测在临床上仍然非常重要。虽然增强 CT 被认为是诊断胰腺坏死的金标准，但由于在发病的最初 48 h 内可能尚未出现全部胰腺坏死，因此早期扫描对严重程度的预测存在局限性。本文综述了目前用于预测重症急性胰腺炎的评分系统和生化标志物，重点介绍了它们的特点和局限性。
