Early Systemic Inflammatory Response Syndrome Is Associated With Severe Acute Pancreatitis
Early Systemic Inflammatory Response Syndrome Is Associated With Severe Acute Pancreatitis
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DOI：
10.1016/j.cgh.2009.08.012
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发表时间：
2009-11-01
影响因子：
12.6
通讯作者：
Banks, Peter A.
中科院分区：
文献类型：
--
作者：
Singh, Vikesh K.;Wu, Bechien U.;Banks, Peter A.
背景与目的：急性胰腺炎患者全身炎症反应综合征（SIRS）的临床研究较少。本研究的目的是评估SIRS在评估急性胰腺炎严重程度中的作用。方法：我们前瞻性地纳入了252例在2005-2007年间直接入住我们机构的急性胰腺炎患者。采用个体严重程度标志物（包括持续性器官衰竭、胰腺坏死、重症监护室需求和死亡率）评价住院前7天内SIRS（一过性48小时）的发生率和持续时间以及住院第1天（第1天）SIRS标准（0-4）的数量。结果：155/252例患者（62%）在第1天发生SIRS。第1天的SIRS以高灵敏度（85%-100%）预测严重疾病。第1天无SIRS与高阴性预测值（98%-100%）相关。第1天全身炎症反应（SIR）标准较高且持续SIRS的患者发生严重疾病的风险增加（P <0.01）。结论：大多数急性胰腺炎住院患者在第1天出现SIRS。与第1天无SIRS的患者相比，第1天有SIRS的患者，特别是有3或4个SIRS标准的患者，急性胰腺炎的严重程度更高。
BACKGROUND & AIMS: There have been few clinical Studies of systemic inflammatory response syndrome (SIRS) in patients with acute pancreatitis. The aim of this study was to evaluate the role of SIRS in assessing severity of acute pancreatitis. METHODS: We prospectively enrolled 252 consecutive patients with acute pancreatitis who were admitted directly to our institution between 2005-2007. The incidence and duration of SIRS (transient 48 hours) during the first 7 days of hospitalization, and the number of SIRS criteria (0-4) on the first day of hospitalization (day 1) were evaluated with individual markers of severity, including persistent organ failure, pancreatic necrosis, need for intensive care unit, and mortality. RESULTS: SIRS occurred in 155/252 patients (62%) on day 1. SIRS on day I predicted severe disease with high sensitivity (85%-100%). The absence of SIRS on day I was associated with a high negative predictive value (98%-100%). Patients with a higher number of systemic inflammatory response (SIR) criteria on day I and persistent SIRS had an increased risk for severe disease (P < .01). CONCLUSIONS: The majority of patients hospitalized with acute pancreatitis have SIRS on day 1. The severity of acute pancreatitis is greater among patients with SIRS on day 1 and, in particular, among those with 3 or 4 SIRS criteria, compared with those without SIRS on day 1.