Relationship between the degree of severe acute pancreatitis and patient immunity

Purpose To investigate the relationship between the APACHE II score and the immunity of patients with severe acute pancreatitis. Methods Clinical data were collected from 88 patients with acute pancreatitis, divided into four groups according to the severity of the disease. C-reactive protein (CRP),...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2015-08, Vol.45 (8), p.1009-1017
Main Authors: Shen, Yinfeng, Deng, Xiaochuan, Xu, Nai, Li, Yan, Miao, Bin, Cui, NaiQiang
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aged
APACHE
Biomarkers - blood
C-Reactive Protein - analysis
Endotoxins - blood
Female
Humans
Immunocompromised Host
Inflammation Mediators - blood
Interleukin-10 - blood
Interleukin-4 - blood
Interleukin-6 - blood
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Pancreatitis - immunology
Severity of Illness Index
Surgery
Surgical Oncology
Tumor Necrosis Factor-alpha - blood
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Summary:Purpose To investigate the relationship between the APACHE II score and the immunity of patients with severe acute pancreatitis. Methods Clinical data were collected from 88 patients with acute pancreatitis, divided into four groups according to the severity of the disease. C-reactive protein (CRP), tumor necrosis factor-α, interleukin-6, interleukin-10, interleukin-4 and endotoxin (ET) in serum were measured on admission and then on days 3, 5, and 7. Results The incidence of local complications and multiple organ dysfunction syndrome increased with a higher APACHE II score. The CRP levels were increased significantly on day 3 in all four groups, but remained high only in the extremely severe group. In the mild and moderate groups, the pro-/anti-inflammatory cytokines peaked on day 3 and then decreased slowly. In the severe and extremely severe groups, the proinflammatory cytokines levels peaked on days 3 and 5, and then decreased rapidly. The antiinflammatory cytokines increased progressively on days 3, 5 and 7. The ET levels peaked significantly and then decreased slowly in the mild, moderate and severe groups, but remained high in the extremely severe group. Conclusions An APACHE II score of 16 or higher is predictive of more local and systemic complications, excessive immune response, and premature immunosuppression.
ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-014-1083-1