急性胰腺炎患者病情严重程度与胸腔积液的相关性研究.

Objective: To investigate the correlation of disease severity with pleural effusion in patients with acute pancreatitis (AP). Methods: A retrospective analysis was conducted on a prospectively collected database. The demographic, clinical, and laboratory data of 492 consecutive cases of AP in patients admitted to the Yunnan Third Peoples' Hospital from January 2008 to December 2014 were reviewed. Acute physiology and chronic health evaluation I (APACHE I) score and computed tomography severity index (CTSI) were used to evaluate the disease severity of AP. The relationship between the severity and pleural effusion was analyzed. Receiver operator characteristic (ROC) curve was used to compare the values of APACHE I score and CTSI in predicting the prognosis of AP patients with pleural effusion. Results: Among the 492 patients, there were 368 patients with pleural effusion and 124 patients without pleural effusion. The incidence of pleural effusion in AP was 74.8%. Further study showed that the difference in the incidences of pleural effusion between the severe group and the mild group was significant (P<0.01). There was a trend that the more serious the patients' condition, the more the pleural effusion. Moreover, the level of pleural effusion was significantly and positively correlated with the APACHE I score (r=0.775, P<0.01) and CTSI (r=0.525, P<0.05). Logistic regression analysis showed that high APACHE I score and high CTSI were significantly associated with pleural effusion formation. Areas under the ROC curve of the APACHE I score, CTSI and combined assessment were 0.798, 1.687 and 0.812 for predicting mortality of AP patients with pleural effusion. There were significant differences between the APACHE I score and CTSI as well as combined assessment and CTSI (P<0.05). Conclusion: The disease severity was closely related to pleural effusion in patients with AP. Combining the two scoring systems to evaluate the disease severity and providing active treatment were important to improve the prognosis of APC patients with pleural effusion. [ABSTRACT FROM AUTHOR]