基于肺炎指数评估急性胰腺炎相关性肺损伤 程度及临床价值研究

Study on the Evaluation of Acute Pancreatitis-Associated Lung Injury Severity and Clinical Value Based on the Pneumonia Index

摘要: 目的：探究肺炎指数(Pneumonia Index, PII)半定量评估法在急性胰腺炎相关性肺损伤(Acute Pancreatitis-Associated Lung Injury, APALI)严重程度分级中的应用效能，及其在临床预后评估中的价值。方法：回顾性选取2019年1月~2023年5月于本院确诊治疗的110例急性胰腺炎(Acute Pancreatitis, AP)患者，收集其临床资料与影像学检查结果，依据修订版亚特兰大标准将患者分为轻症组(Mild Acute Pancreatitis, MAP)、中重症组(Moderately Severe Acute Pancreatitis, MSAP)和重症组(Severe Acute Pancreatitis, SAP)。采用肺炎指数对患者肺部CT表现进行半定量评估与分级，分析该指数与改良CT严重指数(Modified CT Severity Index, MCTSI)、Balthazar分级之间的相关性。结果：110例患者中，104例(94.5%)经影像学检查发现存在肺损伤表现；肺炎指数与MCTSI评分呈显著正相关(r = 0.453, P < 0.001)，Balthazar分级与肺炎指数也存在明显的统计学关联(P = 0.01)。APALI的肺部CT影像学表现具有多样性，主要包括磨玻璃影、肺实变、胸腔积液等类型。结论：肺炎指数与改良CT严重指数、Balthazar分级均存在显著相关性，提示肺炎指数可作为评估APALI严重程度的有效影像学生物标志物，为临床病情判断提供参考依据。

Abstract: Objective: To explore the efficacy of semi-quantitative assessment based on Pneumonia Index (PII) in grading the severity of acute pancreatitis-associated lung injury (APALI) and its value in clinical prognostic evaluation. Methods: A retrospective study was conducted on 110 patients with acute pancreatitis (AP) diagnosed and treated in our hospital from January 2019 to May 2023. Their clinical data and imaging examination results were collected, and the patients were divided into mild acute pancreatitis group (MAP), moderately severe acute pancreatitis group (MSAP) and severe acute pancreatitis group (SAP) according to the revised Atlanta criteria. The Pneumonia Index was used for semi-quantitative assessment and grading of pulmonary CT findings, and the correlation between PII and Modified CT Severity Index (MCTSI), as well as Balthazar grade was analyzed. Results: Among the 110 patients, 104 cases (94.5%) were found to have lung injury by imaging examination; PII was positively correlated with MCTSI score (r = 0.453, P < 0.001), and there was a significant statistical correlation between Balthazar grade and PII (P = 0.01). The pulmonary CT imaging manifestations of APALI were diverse, mainly including ground-glass opacities, pulmonary consolidation, pleural effusion and other types. Conclusion: PII has a significant correlation with MCTSI and Balthazar grade, suggesting that PII can be used as an effective imaging biomarker for evaluating the severity of APALI and providing a reference for clinical condition judgment.