目的：比较急性生理学及慢性健康状况Ⅱ(acute physiology and chronic health evaluationⅡ，APACHE Ⅱ)评分、Ranson评分及腹部CT胰腺外炎症 (extrapancreatic inflammation on abdominal computed tomography，EPIC)评分预测急性胰腺炎（acute pancreatitis，AP）预后的价值。方法：临床资料完整的AP患者198例，其中确诊为重症急性胰腺炎（severe acute pancreatitis，SAP）60例，轻症急性胰腺炎（mild acute pancreatitis，MAP）138例，采用受试者工作特性曲线分析APACHE Ⅱ评分、Ranson评分、EPIC评分预测AP的病情严重程度、并发症的价值。结果：198例患者中，SAP和MAP 患者APACHE Ⅱ评分、Ranson评分、EPIC评分分值比较差异有统计学意义（均为P＜0.01）。EPIC评分标准判断SAP的敏感度、特异度最高，曲线下面积最大，且其预测局部并发症的曲线下面积最大，而APACHE Ⅱ评分预测全身并发症的曲线下面积最大。结论：对入院24 h内的AP患者，EPIC评分结合APACHE Ⅱ评分能有效预测其预后，而Ranson评分不具优势。
Abstract
Objective: To compare the value of acute physiology and chronic health evaluationⅡ(APACHE Ⅱ) score，Ranson score and extrapancreatic inflammation on abdominal ?computed tomography(EPIC) score in predicting outcomes of patients with acute pancreatitis（AP）. Methods: One hundred and ninety-eight patients diagnosed as AP with completed data were studied. Among 198 patients，sixty were severe acute pancreatitis（SAP） and others were mild acute pancreatitis（MAP）. The value of APACHE Ⅱ score, Ranson score and EPIC score were assessed using by receiver operator characteristic（ROC）curve in predicting severity and complications of AP. Results：Among 198 patients, the APACHE Ⅱ score，Ranson score and EPIC score were significantly higher in SAP group than those in MAP group (all P＜0.01). EPIC score had the best sensitivity，specificity and the area under ROC curve (AUROC) for predicting SAP, and had the greatest AUROC to predict local complications. However, the APACHE Ⅱ score had the greatest AUROC to predict systemic complications. Conclusion：In patients with AP，combined EPIC score and APACHE Ⅱscore can estimate outcomes accurately within 24 h of admission, but the Ranson score has no advantages.
