Clinical Significant Of Coagulation Function And Mechanism In Acute Pancreatitis

To evaluate clinical significance of the alteration of coagulationfunction and cytokin in acute pancreatitis (AP).There were two parts inthe study. In part one: Data were analyzed of 82 petients with acutepancreatitis who were admited in Tianjin Medical University GeneralHospital from 10/2005 to 12/2006. Patients were divided into the mildacute pancreatitis (MAP) group and severe acute pancreatitis (SAP)group according to "The standard of clinical diagnosis and the classifyin acute pancreatitis"(To formulate by the pancreaopathy group ofChinese surgery college 1996). Prothrombin time (PT), partiallyactivated thrombopastin time (APTT),Fibranogen (FIB), D-dimer (D-D)and APACHEⅡscore were detected. In part two: Data were analyzed of35 petients with acute pancreatitis who were admited in Tianjin MedicalUniversity General Hospital from 9/2006 to 3/2007. Patients weredivided into the mild acute pancreatitis (MAP) group and severe acutepancreatitis (SAP) group. Patients were divided into the MODS groupand the non-MODS group in another way. PT,APTT, FIB, D-D,Tumornecrosis(TNF), platelet activatingactor(PAF),interlukin-6 and nitric oxide(NO)were detected on 0d, 1d, 3d and 7d after administration. Resultsappeared with respect to PT, APTT, FIB and D-D,there was significantdifference between severe acute pancreatitis (SAP) and mild acutepancreatitis (MAP) groups (p＜0.01); there was significant differencebetween MODS and non MODS groups (p＜0.01).There was nosignificant correlation between PT, APTT, FIB,D-D and APACHEⅡscore in MAP group (p＞0.05), while the correlation betweenPT, APTT, FIB,D-D and APACHEⅡscore in SAP group (p＜0.05). Withrespect to PT, APTT, FIB and D-D,there was significant differencebetween severe acute pancreatitis (SAP) and mild acute pancreatitis (MAP) groups (p＜0.05); there was significant difference betweenMODS and non MODS groups (p＜0.05).FIB level was highest on 0dand descent gradually.D-D level was highest on 1d.The change of FIBwere coincident to TNF as same as D-D and PAF,IL-6. The study showedthat the coagulation system appeared dysfunction in AP patients.Detection of coagulation function in AP patients is suggestive ofprognosis of patients. The coagulation function was activatid at theealier period of AP and fibrinolytic system was followed. Thecoagulation function in AP patients played an important role in themicrocirculation dysfunction.