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.
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), tumornecrosis 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.
Authors: Maher O Osman; Borbala Gesser; Janne T Mortensen; Kouji Matsushima; Steen L Jensen; Christian G Larsen Journal: Cytokine Date: 2002-01-07 Impact factor: 3.861
Authors: Enrique de-Madaria; Juan Martínez; Laura Sempere; Beatriz Lozano; José Sánchez-Payá; Francisco Uceda; Miguel Pérez-Mateo Journal: Pancreas Date: 2008-10 Impact factor: 3.327
Authors: Arif A Khan; Dilip Parekh; Young Cho; Richard Ruiz; Robert R Selby; Nicolas Jabbour; Yuri S Genyk; Rodrigo Mateo Journal: Arch Surg Date: 2002-10