Objective  To systematically evaluate the risk factors of acute pancreatitis (AP) patients complicating acute lung injury (ALI)/acute respiratory distress syndrome (ARDS).

Methods  CNKI, WanFang Data, VIP, CBM, PubMed, Embase, and Web of Science were searched to collect studies on the risk factors of concurrent ALI/ARDS in patients with AP from the establishment of the databases to October 2023. Literature screening, data extraction, and quality assessment were conducted independently by two researchers according to the inclusion and exclusion criteria. RevMan 5.4 and Stata 14.0 softwares were used for data analysis.

Results  Twenty-eight studies were finally included, which included 7 130 AP patients, including 1  684 AP patients with concurrent ALI/ARDS, and involved 25 risk factors for concurrent ALI/ARDS in AP patients.

Results of Meta- analysis showed that respiratory rate [OR=1.19, 95%CI (1.04, 1.35), P<0.001], respiratory rate > 30  times/ min [OR=1.99, 95%CI (1.02, 3.87), P=0.043], blood glucose [OR=2.70, 95%CI (1.83, 3.98), P<0.001], red blood cell distribution width [OR=2.47, 95%CI (1.79, 3.42), P<0.001], blood lactic acid [OR=2.48, 95%CI (1.34, 4.61), P=0.004], C-reactive protein [OR=1.08, 95%CI (1.05, 1.12), P=0.001], white blood cell [OR=1.13, 95%CI (1.00, 1.27), P=0.04], polymorphonuclear [OR=1.36, 95%CI (1.05, 1.78), P=0.02] levels increased, and albumin [OR=1.45, 95%CI(1.25, 1.70), P<0.001], Ca²⁺[OR=6.95, 95%CI (3.54, 13.66), P<0.001], and albumin  <30  g/ L [OR=1.96, 95%CI (1.26, 3.05), P=0.003], acute physiology and chronic health evaluation II (APACHE II) [OR=1.52, 95%CI(1.31, 1.76), P<0.001], Ranson score [OR=2.38, 95%CI(1.53, 3.70), P<0.001], CT severity index (CTSI) score [OR=1.72, 95%CI(1.58, 1.88), P<0.001], APACHE II score >11 [OR=1.80, 95%CI (1.12, 2.91), P=0.016], Ranson score >5 [OR=1.97, 95%CI (1.25, 3.09), P=0.003], infection [OR=5.72, 95%CI (3.27, 10.00), P<0.001] were risk factors for ALI/ARDS in patients with AP.

Conclusion  There were many risk factors for the complication of ALI/ARDS in patients with AP, and clinical healthcare professionals should actively monitor the relevant risk factors, give early warning and identify the high-risk groups for the complication of ALI/ARDS in patients with AP in order to take timely and effective prevention and treatment measures to reduce the incidence and mortality of ALI/ARDS in patients with AP, and improve the  prognosis of patients.

1.Iannuzzi JP, King JA, Leong JH, et al. Global incidence of acute pancreatitis is increasing over time: a systematic review and meta-analysis[J] Gastroenterology, 2022, 162(1): 122-134. DOI: 10.1053/j.gastro.2021.09.043.

2.高明, 王琪, 孙远松, 等. circZMYM2/miR-29a/PUMA轴对急性胰腺炎腺泡细胞凋亡的影响及作用机制 [J]. 中国普通外科杂志, 2023, 32(9): 1341-1348. [Gao M, Wang Q, Sun YS, et al. Impact of the circZMYM2/miR-29a/PUMA axis on acinar cell apoptosis in acute pancreatitis and its action mechanism[J]. Chinese Journal of General Surgery, 2023, 32(9): 1341-1348.] DOI: 10.7659/j.issn.1005-6947.2023.09.007.

3.Boxhoorn L, Voermans RP, Bouwense SA, et al. Acute pancreatitis[J]. Lancet, 2020, 396(10252): 726-734. DOI: 10.1016/S0140-6736(20)31310-6.

4.Iyer H, Elhence A, Mittal S, et al. Pulmonary complications of acute pancreatitis[J]. Expert Rev Respir Med, 2020, 14(2): 209-217. DOI: 10.1080/17476348.2020.1698951.

5.Yang Q, Luo Y, Lan B, et al. Fighting fire with fire: exosomes and acute pancreatitis-associated acute lung injury[J]. Bioengineering (Basel), 2022, 9(11): 615. DOI: 10.3390/bioengineering9110615.

6.Gajendran M, Prakash B, Perisetti A, et al. Predictors and outcomes of acute respiratory failure in hospitalised patients with acute pancreatitis[J]. Frontline Gastroenterol, 2020, 12(6): 478-486. DOI: 10.1136/flgastro-2020-101496.

7.俞正秋, 马春芳, 蔡宛如. 急性肺损伤/急性呼吸窘迫综合征治疗进展[J]. 中国现代医生, 2021, 59(13): 189-192. [Yu ZQ, Ma CF, Cai WR. Advances in the treatment of acute lung injury/acute respiratory distress syndrome[J]. China Modern Doctor, 2021, 59(13): 189-192.] https://www.cqvip.com/doc/journal/951022070

8.中华医学会重症医学分会. 急性肺损伤/急性呼吸窘迫综合征诊断和治疗指南（2006）[J]. 中华急诊医学杂志, 2007, 16(4): 343-349. [Society of Critical Care Medicine, Chinese Medical Association. Guideline for diagnosis and treatment of acute lung injury/acute respiratory distress syndrome (2006)[J]. Chinese Journal of Emergency Medicine, 2007, 16(4): 343-349.] DOI: 10.3760/j.issn:1671-0282.2007.04.002.

9.ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin Definition[J]. JAMA, 2012, 307(23): 2526-2533. DOI: 10.1001/jama.2012.5669.

10.曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具[J]. 中国循证心血管医学杂志, 2012, 4(4): 297-299. [Zeng XT, Liu H, Chen X, et al. Fourth part of series of Meta-analysis: quality evaluation tools for observational studies[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2012, 4(4): 297-299.] DOI: 10.3969/j.1674-4055.2012.04.004.

11.范志伟, 谢振林, 毕正强. 白介素-6联合红细胞分布宽度血管外肺水指数对重症急性胰腺炎并发急性呼吸窘迫综合征的预测价值[J]. 河北医学, 2023, 29(8): 1302-1308. [Fan ZW, Xie ZL, Bi ZQ. Predictive value of IL-6 combination with RDW and extravascular lung water index in severe acute pancreatitis complicated by ARDS[J]. Hebei Medicine, 2023, 29(8): 1302-1308.] DOI: 10.3969/j.issn.1006-6233.2023.08.014.

12.吴薇, 肖影, 王健, 等. CRP/Alb、NLR、PLR联合检测对重症急性胰腺炎合并ARDS的预测价值[J]. 疑难病杂志, 2023, 22(9): 951-955. [Wu W, Xiao Y, Wang J, et al. The predictive value of combined detection of CRP/Alb, NLR, and PLR in severe acute pancreatitis with ARDS[J]. Chinese Journal of Difficult and Complicated Cases, 2023, 22(9): 951-955.] DOI: 10.3969/j.issn.1671- 6450.2023.09.011.

13.迟骋, 周颖, 宋小静, 等. 急性胰腺炎并发急性呼吸窘迫综合征早期预警模型的建立及诊断价值分析[J]. 中华急诊医学杂志, 2023, 32(8): 1046-1052. [Chi C, Zhou Y, Song XJ, et al. Establishment and diagnostic value of an early warning model for acute pancreatitis complicated with acute respiratory distress syndrome[J]. Chinese Journal of Emergency Medicine, 2023, 32(8): 1046-1052.] DOI: 10.3760/cma.j.issn.1671-0282.2023.08.007.

14.赵雅彬, 李琨琨, 张志伟, 等. 急性胰腺炎患者外周血线粒体DNA水平变化及其对合并急性肺损伤的预测价值[J]. 临床内科杂志, 2023, 40(2): 119-121. [Zhao YB, Li KK, Zhang ZW, et al. Changes of mitochondrial DNA levels in peripheral blood of patients with acute pancreatitis and their predictive value in patients with acute lung injury[J]. Journal of Clinical Internal Medicine, 2023, 40(2): 119-121.] DOI: 10.3969/j.issn.1001-9057.2023.02.014.

15.李勋, 王厚清, 许铁. 重症急性胰腺炎患者入院24小时后新发急性呼吸窘迫综合征的危险因素分析[J] 临床内科杂志, 2022, 39(1): 22-25. [Li X, Wang HQ, Xu T. Analysis of risk factors of new acute respiratory distress syndrome in patients with severe acute pancreatitis after 24 hours of admission[J]. Journal of Clinical Internal Medicine, 2022, 39(1): 22-25.] DOI: 10.3969/j.issn.1001-9057.2022.01.007.

16.李志芳, 刘巧雅, 张蓓. 重症加强护理病房重症急性胰腺炎患者发生急性呼吸窘迫综合征的高危因素[J]. 河南医学研究, 2022, 31(4): 634-637. [Li ZF, Liu QY, Zhang B. High-risk factors of acute respiratory distress syndrome in patients with severe acute pancreatitis in intensive care unit[J]. Henan Medical Research, 2022, 31(4): 634-637.] DOI: 10.3969/j.issn.1004-437X.2022. 04.015.

17.韩坤, 郭秉楠. NLR、RDW联合MPV对急性胰腺炎并发急性呼吸窘迫综合征的预测价值[J]. 交通医学, 2021, 35(3): 232-234. [Han K, Guo BN. The value of NLR,RDW combined with MPV in the evaluation of acute pancreatitis combined with acute respiratory distress syndrome[J]. Medical Journal of Communications, 2021, 35(3): 232-234.] DOI: 10.19767/j.cnki.32-1412.2021. 03.005.

18.张鹏, 王蒙蒙, 孙兆瑞, 等. 急性胰腺炎并发急性呼吸窘迫综合征危险因素分析及风险评估模型的建立 [J]. 中国急救医学, 2021, 41(10): 846-851. [Zhang P, Wang MM, Sun ZR, et al. Analysis of risk factors of acute pancreatitis complicated with ARDS and the establishment of risk assessment models[J]. Chinese Journal of Critical Care Medicine, 2021, 41(10): 846-851.] DOI: 10.3969/j.issn.1002-1949.2021.10.003.

19.卢洪军, 厉兵, 崔乃强, 等. 重症急性胰腺炎合并ARDS早期风险因素分析及预测模型建立[J]. 中国中西医结合急救杂志, 2021, 28(6): 658-661. [Lu HJ, Li B, Cui NQ, et al. Early risk factors analysis and model prediction of severe acute pancreatitis complicated with acute respiratory distress syndrome[J]. Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care, 2021, 28(6): 658-661.] DOI: 10.3969/j.issn.1008-9691.2021.06.003.

20.熊洋洋, 李云龙, 宋锴, 等. 重症急性胰腺炎相关急性呼吸窘迫综合征的临床特征及早期预测[J]. 中华胰腺病杂志, 2021, 21(5): 332-338. [Xiong YY, Li YL, Song K, et al. Clinical characteristics and early prediction of acute respiratory distress syndrome in severe acute pancreatitis[J]. Chinese Journal of Pancreatology, 2021,21(5): 332-338.] DOI: 10.3760/cma.j.cn115667-20210613-00111.

21.胡振奎, 张建国, 张德厚. 重症急性胰腺炎患者并发急性呼吸窘迫综合征的影响因素研究[J]. 实用心脑肺血管病杂志, 2018, 26(12): 54-57. [Hu ZK, Zhang JG, Zhang DH. Influencing factors of acute respiratory distress syndrome in patients with severe acute pancreatitis[J]. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 2018, 26(12): 54-57.] DOI: 10.3969/j.issn.1008-5971.2018.12.012.

22.林燕, 张发钦, 李海涛. 急性胰腺炎并发急性呼吸衰竭的危险因素分析[J]. 中国临床研究, 2018, 31(11): 1500-1503. [Lin Y, Zhang FQ, Li HT. Risk factors for acute pancreatitis complicated with acute respiratory failure[J]. Chinese Journal of Clinical Research, 2018, 31(11): 1500-1503.] DOI: 10.13429/j.cnki.cjcr.2018. 11.015.

23.魏焱, 陈炯, 陈秋星. 老年重症急性胰腺炎病人急性肺损伤的危险因素分析[J]. 腹部外科, 2018, 31(1): 52-55. [Wei Y, Chen J, Chen QX. The risk factors of severe pancreatitis-associated lung injury in elderly patients[J]. Journal of Abdominal Surgery, 2018, 31(1): 52-55.] DOI: 10.3969/j.issn.1003-5591.2018.01.012.

24.张友健, 王瑶, 陈霞, 等. 重症急性胰腺炎并发急性呼吸窘迫综合征危险因素分析及风险评估模型的建立[J]. 山东医药, 2018, 58(2): 1-4. [Zhang YJ, Wang Y, Chen X, et al. Analysis of risk factors and establishment of risk assessment model of SAP complicated with ARDS[J]. Shandong Medical Journal, 2018, 58(2): 1-4.] DOI: 10.3969/j.issn.1002-266X.2018.02.001.

25.章小山. 重症急性胰腺炎患者发生急性期急性肺损伤的危险因素分析[J]. 中国临床新医学, 2016, 9(10): 900-903. [Zhang XS. The risk factors of acute lung injury in acute stage in patients with severe acute pancreatitis[J]. Chinese Journal of New Clinical Medicine, 2016, 9(10): 900-903.] DOI: 10.3969/j.issn.1674-3806.2016.10.17.

26.邵斌霞, 何斌, 刘红梅, 等. 急性重症胰腺炎并发ARDS多因素回归分析[J]. 临床急诊杂志, 2014, 15(8): 449-451, 455. [Shao BX, He B, Liu HM, et al. Multivariate regression analysis for severe acute pancreatitis patients with ARDS[J]. Journal of Clinical Emergency, 2014, 15(8): 449-451, 455.] DOI: 10.13201/j.issn.1009-5918.2014.08.001.

27.潘涛, 黄蕾, 冉红梅, 等. 重症急性胰腺炎并发胰腺炎相关肺损伤的危险因素分析[J]. 实用医院临床杂志, 2013, 10(5): 91-94. [Pan T, Huang L, Ran HM, et al. The clinical study on risk factors of severe acute pancreatitis complicated with pancreatitis associated lung injury[J]. Practical Journal of Clinical Medicine, 2013,10(5): 91-94.] DOI: 10.3969/j.issn.1672-6170.2013.05.029.

28.陈秋星, 吕德超, 曹斌, 等. 重症急性胰腺炎并发急性肺损伤危险因素的临床研究[J]. 肝胆胰外科杂志, 2012, 24(6): 451-454, 458. [Chen QX, Lyu DC, Cao B, et al. Study on risk factors of severe pancreatitis complicated with lung injury[J]. Journal of Hepatopancreatobiliary Surgery, 2012, 24(6): 451-454, 458.] DOI: 10.3969/j.issn.1007-1954.2012.06.004.

29.代晓明, 万献尧. 重症急性胰腺炎并发急性呼吸窘迫综合征危险因素的分析[J]. 医学与哲学, 2009, 30(1): 34-35. [Dai XM, Wan XY. Analysis of risk factors of severe acute pancreatitis complicated with acute respiratory distress syndrome[J]. Medicine & Philosophy, 2009, 30(1): 34-35.] https://www.cqvip.com/doc/journal/976183135

30.胡文炜, 刘庆森. 重症急性胰腺炎并发急性肺损伤的临床研究[J]. 中国误诊学杂志, 2008, 8(2): 253-254. [Hu WW, Liu QS. Clinical research of severe acute pancreatitis complicated lung injury[J]. Chinese Journal of Misdiagnostics, 2008, (2): 253-254.] DOI: 10.3969/j.issn.1009-6647.2008.02.001.

31.Jia M, Xu X, Zhou S, et al. Prediction of acute lung injury in severe acute pancreatitis by routine clinical data [J]. Eur J Gastroenterol Hepatol, 2023, 35(1): 36-44. DOI: 10.1097/MEG.0000000000002458.

32.Lin F, Lu R, Han D, et al. A prediction model for acute respiratory distress syndrome among patients with severe acute pancreatitis: a retrospective analysis[J]. Ther Adv Respir Dis, 2022, 16: 17534666221122592. DOI: 10.1177/17534666221122592.

33.Li YL, Zhang DD, Xiong YY, et al. Development and external validation of models to predict acute respiratory distress syndrome related to severe acute pancreatitis[J]. World J Gastroenterol, 2022, 28(19): 2123-2136. DOI: 10.3748/wjg.v28.i19.2123.

34.Ding N, Guo C, Song K, et al. Nomogram for the prediction of in-hospital incidence of acute respiratory distress syndrome in patients with acute pancreatitis[J]. Am J Med Sci, 2022, 363(4): 322-332. DOI: 10.1016/j.amjms.2021.08.009.

35.Zhang W, Zhang M, Kuang Z, et al. The risk factors for acute respiratory distress syndrome in patients with severe acute pancreatitis: a retrospective analysis[J]. Medicine (Baltimore), 2021, 100(2): e23982. DOI: 10.1097/MD.0000000000023982.

36.Huang Y, Xiao J, Cai T, et al. Immature granulocytes: a novel biomarker of acute respiratory distress syndrome in patients with acute pancreatitis[J]. J Crit Care, 2019, 50: 303-308. DOI: 10.1016/j.jcrc.2018.12.002.

37.Peng YF, Zhang ZX, Cao W, et al. The association between red blood cell distribution width and acute pancreatitis associated lung injury in patients with acute pancreatitis[J]. Open Med (Wars), 2015, 10(1): 176-179. DOI: 10.1515/med-2015-0028.

38.Polyzogopoulou E, Bikas C, Danikas D, et al. Baseline hypoxemia as a prognostic marker for pulmonary complications and outcome in patients with acute pancreatitis[J]. Dig Dis Sci, 2004, 49: 150-154. DOI: 10.1023/b:ddas.0000011617.00308.e3.

39.Ibadov RA, Arifjanov AS, Ibragimov SK, et al. Acute respiratory distress-syndrome in the general complications of severe acute pancreatitis[J]. Ann Hepatobiliary Pancreat Surg, 2019, 23(4): 359-364. DOI: 10.14701/ahbps.2019.23.4.359.

40.Yang D, Kang J, Li Y, et al. Development of a predictive nomogram for acute respiratory distress syndrome in patients with acute pancreatitis complicated with acute kidney injury[J]. Ren Fail, 2023, 45(2): 2251591. DOI: 10.1080/0886022X.2023.2251591.

41.Bellani G, Pham T, Laffey JG. Missed or delayed diagnosis of ARDS: a common and serious problem[J]. Intensive Care Med, 2020, 46(6): 1180-1183. DOI: 10.1007/s00134-020-06035-0.

42.Ge Q, Yao Z, Wang T, et al. Risk factors of the occurence and death of acute respiratory distress syndrome: a prospective multicenter cohort study[J]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 2014, 26(11): 773-779. DOI: 10.3760/cma.j.issn.2095-4352.2014.11.002.

43.de Brabander J, Boers LS, Kullberg RFJ, et al. Persistent alveolar inflammatory response in critically ill patients with COVID-19 is associated with mortality[J]. Thorax, 2023, 78(9): 912-921. DOI: 10.1136/thorax-2023-219989.

44.黄文炼, 刘鸿雁, 祝瑞, 等. 重症急性胰腺炎并发急性呼吸窘迫综合征发病特点、死亡因素分析及风险评估模型的建立[J]. 安徽医药, 2022, 26(6): 1187-1192. [Huang WL, Liu HY, Zhu R, et al. Severe acute pancreatitis complicated with acute respiratory distress syndrome: characteristics, death factors and the establishment of risk assessment model[J]. Anhui Medical and Pharmaceutical Journal, 2022, 26(6): 1187-1192.] DOI: 10.3969/j.issn.1009-6469.2022.06.030.

45.Li X, Yu J, Huang W, et al. Risk factors analysis of acute respiratory distress syndrome in intensive care unit traumatic patients[J]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue, 2018, 30(10): 978-982. DOI: 10.3760/cma.j.issn.2095-4352.2018.010.015.

46.Xiao CH, Wan J, Liu H, et al. Red blood cell distribution width is an independent risk factor in the prediction of acute respiratory distress syndrome after severe burns[J]. Burns, 2019, 45(5): 1158-1163. DOI: 10.1016/j.burns.2019.01.006.

47.Alkhatib A, Price LL, Esteitie R, et al. A predictive model for acute respiratory distress syndrome mortality using red cell distribution width[J]. Crit Care Res Pract, 2020, 2020: 3832683. DOI: 10.1155/2020/3832683.

48.韩思静, 韦祎, 左罗, 等. 血清丙酮酸、乳酸及极低密度脂蛋白胆固醇水平对急性胰腺炎病情进展的预测价值[J]. 标记免疫分析与临床, 2023, 30(7): 1182-1186, 1242. [Han SJ, Wei Y, Zuo L, et al. The predictive value of levels of serum pyruvic acid, lactic acid and very-low-density lipoprotein cholesterol on the progression of acute pancreatitis[J]. Labeled Immunoassays and Clinical Medicine , 2023, 30(7): 1182-1186, 1242.] DOI: 10.11748/bjmy.issn.1006-1703.2023.07.021.

49.廖艳洁, 尤丽, 胡振春. 动脉血乳酸、氧合指数、D-二聚体对老年重症肺炎患者并发急性呼吸窘迫综合征的预测价值[J]. 空军医学杂志, 2021, 37(5): 410-412. [Liao YJ, You L, Hu ZC. Predictive value of arterial blood lactic acid, oxygenation indexes and D-dimer in elderly patients with severe pneumonia complicated with acute respiratory distress syndrome[J]. Aviation Medicine of Air Force, 2021, 37(5): 410-412.] DOI: 10.3969/j.issn.2095-3402.2021.05.012.

50.Ahmed ME, Hamed G, Fawzy S, et al. Lung injury prediction scores: Clinical validation and C-reactive protein involvement in high risk patients[J] Med Intensiva (Engl Ed), 2020, 44(5): 267-274. DOI: 10.1016/j.medin.2019.02.010.

51.张荟杰, 王美红, 王俊平, 等. 中性粒细胞与淋巴细胞比值对急性胰腺炎并发急性呼吸窘迫综合征的预测价值[J]. 中国现代医学杂志, 2019, 29(17): 79-83. [Zhang HJ, Wang MH, Wang JP, et al. Predictive value of neutrophil-lymphocyte ratio and WBC in acute pancreatitis complicated with ARDS[J]. China Journal of Modern Medicine, 2019, 29(17): 79-83.] DOI: 10.3969/j.issn.1005-8982.2019.17.015.

52.Barrett CD, Hsu AT, Ellson CD, et al. Blood clotting and traumatic injury with shock mediates complement-dependent neutrophil priming for extracellular ROS, ROS-dependent organ injury and coagulopathy[J]. 2018, 194(1): 103-117. DOI: 10.1111/cei.13166.

53.张书娟, 王勇, 代晓明, 等. 脓毒症相关急性呼吸窘迫综合征的危险因素及预后分析[J]. 中国急救医学, 2022, 42(4): 331-336. [Zhang SJ, Wang Y, Dai XM, et al. Risk factors and prognosis of sepsis-associated acute respiratory distress syndrome[J]. Chinese Journal of Critical Care Medicine, 2022,42(4): 331-336.] DOI: 10.3969/j.issn.1002-1949.2022.04.011.

54.Li S, Zhang Y, Li M, et al. Serum albumin, a good indicator of persistent organ failure in acute pancreatitis[J]. BMC Gastroenterol, 2017, 17(1): 59. DOI: 10.1186/s12876-017-0615-8.

55.高传书, 曹荣格, 陈秋星. 血清钙、白蛋白及血液浓缩对急性重症胰腺炎并发肺损伤的预测价值[J]. 齐齐哈尔医学院学报, 2013, 34(8): 1102-1104. [Gao CS, Cao RG, Chen QX. Predictive value of serum calcium ion concentration, serum albumin concentration and blood hematocrit of severe acute pancreatitis complicated acute lung injury[J]. Journal of Qiqihar University of Medicine, 2013, 34(8): 1102-1104.] DOI: 10.3969/j.issn.1002-1256.2013.08.005.

56.Pallagi P, Madácsy T, Varga Á, et al. Intracellular Ca2+ signalling in the pathogenesis of acute pancreatitis: recent advances and translational perspectives[J]. Int J Mol Sci, 2020, 21(11): 4005. DOI: 10.3390/ijms21114005.

57.Zhou T, Zheng N, Li X, et al. Prognostic value of neutrophil- lymphocyte count ratio (NLCR) among adult ICU patients in comparison to APACHE II score and conventional inflammatory markers: a multi center retrospective cohort study[J]. BMC Emerg Med, 2021, 21(1): 24. DOI: 10.1186/s12873-021-00418-2.

58.Yang L, Liu J, Xing Y, et al. Comparison of BISAP, Ranson, MCTSI, and APACHE II in predicting severity and prognoses of hyperlipidemic acute pancreatitis in Chinese patients[J]. Gastroenterol Res Pract, 2016, 2016: 1834256. DOI: 10.1155/2016/1834256.

59.赵春玲, 李玉叶, 王秋义, 等. 脓毒症患者并发急性呼吸窘迫综合征的风险预测列线图模型建立[J]. 中华危重病急救医学, 2023, 35(7): 714-718. [Zhao CL, Li YY, Wang QY, et al. Establishment of risk prediction nomograph model for sepsis related acute respiratory distress syndrome[J]. Chinese Critical Care Medicine, 2023, 35(7): 714-718.] DOI: 10.3760/cma.j.cn121430-20230215-00088.

60.Venkatesh NR, Vijayakumar C, Balasubramaniyan G, et al. Comparison of different scoring systems in predicting the severity of acute pancreatitis: a prospective observational study[J]. Cureus, 2020, 12(2): e6943. DOI: 10.7759/cureus.6943.

61.吴永强, 赵景成. Ranson评分在高脂血症性急性胰腺炎病情严重程度评估中的应用价值[J]. 临床和实验医学杂志, 2022, 21(2): 222-225. [Wu YQ, Zhao JC. Predictive value of Ranson score in the classification of moderate to severe hyperlipidemia acute pancreatitis[J]. Journal of Clinical and Experimental Medicine, 2022, 21(2): 222-225.] DOI: 10.3969/j.issn.1671-4695. 2022.02.029.

62.Taydas O, Unal E, Karaosmanoglu AD, et al. Accuracy of early CT findings for predicting disease course in patients with acute pancreatitis[J]. Jpn J Radiol, 2018, 36(2): 151-158. DOI: 10.1007/s11604-017-0709-9.

63.安文慧, 何旭昶, 杨婧, 等. 入院早期评分系统对急性胰腺炎严重程度及预后的预测价值[J]. 临床肝胆病杂志, 2020, 36(6): 1342-1346. [An WH, He XC, Yang J, et al. Value of early admission scoring systems in predicting the severity and prognosis of acute pancreatitis[J]. Journal of Clinical Hepatology, 2020, 36(6): 1342-1346.] DOI: 10.3969/j.issn.1001-5256.2020.06.030.

64.Marstrand-Joergensen MR, Bertilsson S, Kalaitzakis E. Extrapancreatic infections are common in acute pancreatitis and they are related to organ failure: a population-based study[J]. Eur J Gastroenterol Hepatol, 2020, 32(10): 1293-1300. DOI: 10.1097/MEG.0000000000001847.

65.乐杨桦, 曹友德. 炎症反应与免疫抑制在急性胰腺炎中作用的研究进展[J]. 标记免疫分析与临床, 2019, 26(1): 173-176. [Le YH, Cao YD. The research progress of inflammatory response and immunosuppression in acute pancreatitis[J]. Labeled Immunoassays and Clinical Medicine, 2019, 26(1): 173-176.] DOI: 10.11748/bjmy.issn.1006-1703.2019.01.043.