Yang Zhiyong, Zhang Yushun, Dong Liming, Yang Chong, Gou Shanmiao, Yin Tao, Wu Heshui, Wang Chunyou
Pancreatic Disease Institute, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China.
PLoS One. 2015 May 4;10(5):e0125529. doi: 10.1371/journal.pone.0125529. eCollection 2015.
Few data are available on the potential role of inflammatory mediators and T lymphocytes in persistent organ failure (POF) in acute pancreatitis (AP). We conducted a retrospective study to characterize their role in the progression of POF in AP.
A total of 69 AP patients presented within 24 hours from symptom onset developing organ failure (OF) on admission were included in our study. There were 39 patients suffering from POF and 30 from transient OF (TOF). On the 1st, 3rd and 7th days after admission, blood samples were collected for biochemical concentration monitoring including serum IL-1β, IL-6, TNF-α and high-sensitivity C-reactive protein (hs-CRP). The proportions of peripheral CD4(+) and CD8(+) T lymphocytes were assessed based on flow cytometry simultaneously.
Patients with POF showed a significantly higher value of IL-1β and hs-CRP on day 7 compared with the group of TOF (P < 0.05). Proportions of CD4(+) T cells on days 1, 3, 7 and CD4(+)/ CD8(+) ratio on day 1 were statistically lower in the group of POF patients (P < 0.05). A CD4(+) T cell proportion of 30.34% on day 1 predicted POF with an area under the curve (AUC) of 0.798, a sensitivity with 61.54% and specificity with 90.00%, respectively.
The reduction of peripheral blood CD4(+) T lymphocytes is associated with POF in AP, and may act as a potential predictor.
关于炎症介质和T淋巴细胞在急性胰腺炎（AP）持续性器官衰竭（POF）中的潜在作用，可用数据较少。我们进行了一项回顾性研究，以阐明它们在AP患者POF进展中的作用。
本研究纳入了69例在症状发作后24小时内就诊且入院时出现器官衰竭（OF）的AP患者。其中39例为POF患者，30例为短暂性OF（TOF）患者。在入院后的第1天、第3天和第7天，采集血样进行生化指标监测，包括血清白细胞介素-1β（IL-1β）、IL-6、肿瘤坏死因子-α（TNF-α）和高敏C反应蛋白（hs-CRP）。同时采用流式细胞术评估外周血CD4(+)和CD8(+) T淋巴细胞的比例。
与TOF组相比，POF患者在第7天时IL-1β和hs-CRP值显著更高（P < 0.05）。POF患者组在第1天、第3天、第7天的CD4(+) T细胞比例及第1天的CD4(+)/CD8(+)比值在统计学上更低（P < 0.05）。第1天CD4(+) T细胞比例为30.34%时预测POF的曲线下面积（AUC）为0.798，敏感性为61.54%，特异性为90.00%。
外周血CD4(+) T淋巴细胞减少与AP患者的POF相关，可能是一种潜在的预测指标。
