Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.
World J Gastroenterol. 2022 Nov 28;28(44):6206-6212. doi: 10.3748/wjg.v28.i44.6206.
In this editorial we comment on the article published in the recent issue of the [2022; 28 (19): 2123-2136]. We pay attention to how to construct a simpler and more reliable new clinical predictive model to early identify patients at high risk of acute respiratory distress syndrome (ARDS) associated with severe acute pancreatitis (SAP), and to early predict the severity of organ failure from chest computed tomography (CT) findings in SAP patients. As we all know, SAP has a sudden onset, is a rapidly changing condition, and can be complicated with ARDS and even multiple organ dysfunction syndrome, and its mortality rate has remained high. At present, there are many clinical scoring systems for AP, including the bedside index for severity in AP, acute physiology and chronic health evaluation II, systemic inflammatory response syndrome, Japanese severe score, quick sepsis-related organ failure assessment, However, some of these scoring systems are complex and require multiple and difficult clinical parameters for risk stratification. Although the aforementioned biomarkers are readily available, their ability to predict ARDS varies. Accor-dingly, it is extremely necessary to establish a simple and valuable novel model to predict the development of ARDS in AP. In addition, the extra-pancreatic manifestations of AP patients often involve the chest, among which pleural effusion and pulmonary consolidation are the more common complications. Therefore, by measuring the semi-quantitative indexes of chest CT in AP patients, such as the amount of pleural effusion and the number of lobes involved as pulmonary consolidation, it has important reference value for the early diagnosis of SAP complicated with ARDS and is expected to provide a basis for the early treatment of ARDS.
在这篇社论中，我们对近期发表在[2022；28（19）：2123-2136]上的文章进行了评论。我们关注的是如何构建一个更简单、更可靠的新临床预测模型，以早期识别与重症急性胰腺炎（SAP）相关的急性呼吸窘迫综合征（ARDS）高危患者，并根据 SAP 患者胸部计算机断层扫描（CT）结果早期预测器官衰竭的严重程度。众所周知，SAP 发病突然，病情变化迅速，可并发 ARDS 甚至多器官功能障碍综合征，死亡率居高不下。目前，AP 的临床评分系统很多，包括急性生理和慢性健康评估 II、全身炎症反应综合征、日本重症评分、快速脓毒症相关器官衰竭评估等，但是，其中一些评分系统比较复杂，需要多个和困难的临床参数进行风险分层。尽管上述生物标志物易于获得，但它们预测 ARDS 的能力各不相同。因此，建立一个简单而有价值的新型模型来预测 AP 中 ARDS 的发展是非常必要的。此外，AP 患者的胰腺外表现常累及胸部，其中胸腔积液和肺实变较为常见。因此，通过测量 AP 患者胸部 CT 的半定量指标，如胸腔积液量和肺实变累及的肺叶数，对 SAP 并发 ARDS 的早期诊断具有重要的参考价值，并有望为 ARDS 的早期治疗提供依据。
