吴双强,李琳业

急性胰腺炎（acute pancreatitis，AP）病程异质性显著，约20%进展为重症急性胰腺炎（severe acute pancreatitis，SAP），死亡率20%-40%，早期精准预测其严重程度及预后是临床诊疗的关键。本文从传统评分系统、血清学指标、影像学指标及新兴预测技术四方面，综述AP预测指标研究进展。传统评分系统（APACHEⅡ、BISAP、Ranson评分）为临床基础工具，但时效性与精准度欠佳；血清学中，传统酶学指标仅用于诊断，NLR、IL-6、RDW、LDL-C及BUN动态变化具有良好早期预测价值；CT评分系统（CTSI、MCTSI）可直观评估胰腺损伤，MRI与超声作为补充各有优劣；机器学习（ML）模型整合多源数据，预测效能优于传统工具。新型检测技术及分子标志物提供新方向。当前领域存在标志物检测标准不统一、ML模型转化难、多中心研究不足等问题。未来需聚焦标志物标准化、ML模型优化及整合体系构建，实现AP早期精准个体化评估，支撑诊疗决策，改善患者预后。

急性胰腺炎；重症急性胰腺炎；预测指标；生物标志物；机器学习

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