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目的：分析和评价Ranson、Glasgow、APACHEⅡ和BISAP 4种临床评分标准对急性胰腺炎严重程度的评估价值。方法：回顾性研究急性胰腺炎患者225 例，分别应用APACHEⅡ、Ranson、Glasgow 及BISAP 评分标准对急性胰腺炎患者进行评分，比较分析不同评分标准对该类患者诊断的敏感性、特异性，以及对合并脏器功能不全的预测情况。结果：225例患者中，轻型胰腺炎188 例，重型胰腺炎37 例，在轻型和重型胰腺炎患者中，4 种评分标准分值差异均有统计学意义( P < 0.01)。47 例患者存在器官功能不全，4 种评分标准与患者合并脏器功能不全均显著相关。各评分标准中，APACHEⅡ对急性重症胰腺炎评估的敏感性、特异性最好，分别为76%和72%。结论：4 中评分方法各有特点，综合应用可能更准确的评估疾病严重程度及预后。

英文摘要:

Objective: To investigate the accuracy of four clinical diagnostic criteria systems Ranson, Glasgow, APACHEⅡ and BISAP in the prediction of severity acute pancreatitis.Methods:225 patients with acute pancreatitis were retrospectively studied with these four criteria systems. The sensitivity, specificity, PPV, NPV and the combine with multiple organ failure of severe acute pancreatitis of these four systems were assessed.Results:Among 225 patients, mild acute pancreatitis (MAP) was identified in 188 patients, and severe acute pancreatitis (SAP) was identified in 37 patients. The mean scores of Ranson, Glasgow, APACHEⅡ, BISAP between MAP and SAP were statistical and significant difference (P<0.01). The sensitivity and specificity of APACHEⅡ was the highest (76% and 72%) in predicting severe acute pancreatitis outcomes. The scores of the four systems were correlated significantly with multiple organ failure.Conclusion:Four scoring methods have different characteristics. The accuracy may be improved by the comprehensive assessment in predicting the severity of the disease.

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