Wang Yu, Qu Guangbo, Wu Zhangbi, Tian Dongmei, Yang Wenbei, Li Hongye, Lu Yu, Meng GuangJun, Zhang Hong
Department of Emergency Medicine, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Anhui Medical University, Hefei, Anhui, China.
Therap Adv Gastroenterol. 2023 Apr 17;16:17562848231167277. doi: 10.1177/17562848231167277. eCollection 2023.
Currently, no guidelines specifically recommend scoring systems and biomarkers for early evaluation of the severity and prognosis of acute pancreatitis in pregnancy (APIP).
This study aimed to explore the early predictive value of scoring systems and routine laboratory tests on APIP severity and maternofetal prognosis.
This study retrospectively analyzed 62 APIP cases in a 6-year period.
The predictive value of scoring systems and routine laboratory tests that were collected 24 h and 48 h after admission, for APIP severity and fetal loss, were analyzed.
To detect severe acute pancreatitis (SAP), a 24-h Bedside Index for severity in acute pancreatitis (BISAP) achieved a higher area under the curve (AUC) value of 0.910 than the Acute Physiology and Chronic Health Evaluation II (AUC = 0.898) and Ranson score (AUC = 0.880). The combination of BISAP, glucose, neutrophil-to-lymphocyte ratio (NLR), hematocrit (Hct), and serum creatinine (Scr) provided an AUC value of 0.984, which had greater predictive power than BISAP ( = 0.015). 24-h BISAP and Hct were independent risk factors for predicting SAP of APIP. The cutoff values of Hct and blood urea nitrogen (BUN) to predict SAP were 35.60% and 3.75 mmol/l in the APIP. Furthermore, 24-h BISAP had the highest predictive power (AUC = 0.958) for fetal loss.
BISAP is a convenient and reliable indicator for the early prediction of SAP and fetal loss in APIP. The combination of BISAP, glucose, NLR, Hct and Scr proved to be the optimal early markers for the prediction of SAP in APIP within 24 h after admission. In addition, Hct > 35.60% and BUN > 3.75 mmol/l may be suitable thresholds for predicting SAP in APIP.
目前，尚无指南专门推荐用于早期评估妊娠期急性胰腺炎（APIP）严重程度和预后的评分系统及生物标志物。
本研究旨在探讨评分系统和常规实验室检查对APIP严重程度及母胎预后的早期预测价值。
本研究回顾性分析了6年间的62例APIP病例。
分析入院后24小时和48小时收集的评分系统及常规实验室检查对APIP严重程度和胎儿丢失的预测价值。
为检测重症急性胰腺炎（SAP），急性胰腺炎床边严重程度指数（BISAP）在24小时时的曲线下面积（AUC）值为0.910，高于急性生理与慢性健康状况评分系统II（AUC = 0.898）和兰森评分（AUC = 0.880）。BISAP、血糖、中性粒细胞与淋巴细胞比值（NLR）、血细胞比容（Hct）和血清肌酐（Scr）的组合AUC值为0.984，其预测能力高于BISAP（P = 0.015）。24小时BISAP和Hct是预测APIP的SAP的独立危险因素。APIP中预测SAP的Hct和血尿素氮（BUN）的截断值分别为35.60%和3.75 mmol/L。此外，24小时BISAP对胎儿丢失的预测能力最高（AUC = 0.958）。
BISAP是早期预测APIP中SAP和胎儿丢失的便捷可靠指标。BISAP、血糖、NLR、Hct和Scr的组合被证明是入院后24小时内预测APIP中SAP的最佳早期标志物。此外，Hct > 35.60%和BUN > 3.75 mmol/L可能是预测APIP中SAP的合适阈值。
