Significance On Systemic Inflammatory Response Syndrome And Changes Of Serum Cytokines In Acute Phase Of Acute Pancreatitis

Objective: To study the onset, duration and severity of systemic inflammatory response syndrome (SIRS) in early stage of acute pancreatitis(AP),and to explore the role of cytokines in the progression of acute pancreatitis.Methods: 86 patients were diagnosed as acute pancreatitis in our hospital from 2000 to 2002, and 30 healthy volunteers (15 male and 15 female) as control group. The morbidity of SIRS in mild acute pancreatitis(MAP) and in severe acute pancreatitis (SAP) was calculated and compared with each other. Based on the presence or absence of SIRS in the course, the AP patients were grouped as non-SIRS and SIRS to study the onset, duration and severity of SIRS in AP. Plasma TNF- a , IL-1β , IL-6 and IL-8 were determined by ELISA in AP patients. TNF-a , IL-1β , IL-6 and IL-8 were determined on alternative days in SAP patients to study the role of cytokines in the progression of acute pancreatitis.Results: The morbidity of SIRS in SAP was higher than that in the mild group of AP(P<0.01). The mortality in AP patients increased with the severity of SIRS (p<0.05). The plasma levels of TNF- a , IL-1β, IL-6 and IL-8 in MAP or SAP patients were significantly higher than those in control group(P<0.05, P<0.01), and these changes were corresponding to the clinical symptoms.Conclusions: The prognosis of AP is highly related to the onset, duration and severity of SIRS in AP. Cytokines are involved in the pathological progression of acute pancreatitis and are important factors for tissue injury.