The Relations Between The Severity Of Acute Pancreatitis And The Change Of Blood Coagulation System In Acute Pancreatitis

Background: Acute pancreatitis(AP) is one of most common diseases in alimentary system emergency case. The morbidity has continued to rise in recent years, particularly the mortality of severe acute pancreatitis are still more than 20%-30%,Acute pancreatitis remains a more dangerous disease. So the early predict and correctly assess the severity of acute pancreatitis, Which is particularly important to avoid the transformation from mild acute pancreatitis to serious acute pancreatitis in clinical work. Otherwise, It can,not completely understand the pathogenesy of AP. Now it,s believed that it has the disorder of the coagulating function is really exist. the disorder can make the pancreatitis more serious. It is reported that the anticoagulant therapy improves the situation of AP and it is possible one of methods of the anticoagulant therapy. although the research of coagulation disorder of AP had be reported. But there haven,t the record of the research about the correlation between therapy based on pathological nature severity index of AP and coagulation disorders.Objective: To find out the relations between the severity of acute pancreatitis and the change of blood coagulation system in acute pancreatitis. To evaluate the relations between Acute physiology and chronic health evaluation(APACHEâ…¡)score, Ranson evaluation score, Balthazar computed tomography(CT)score and the changes of Prothrombin time(PT),partially activited Thromboplastin time(APTT), Fibrinogen(Fib ) and D-dimer with pancreatitis.Methods: We collected 34 cases of AP admitted to First Hospital of dalian Medicial, University from year 2006 to year 2007, 16 males and 18 females, aged between 20 and 81. The effect of anticoagulant was depleted. According to APACHE evaluationâ…¡score and Ranson evaluation score divided it into two types: mild acutepancreatitis (MAP) 22 cases and severe acute pancreatitis (SAP) 12 cases. Normal control 11 cases. PT, APTT,Fib and D-dimer of 33 patients in Ap and normal control group were detected By full automatic blood coagulation analyzer. Results in within the initial 24hours of hospitalization. PT, APTT,Fib and D-dimer were measured with nephelomitermeusure method. meanwhile, a CT examination is made within the initial 24hours of hospitalizaion. To record their APACHEâ…¡score, Ranson score and CT score Within the initial 24hours of hospitalization. As well as to make correlation analysis with PT,Fib,APTT,D-dimer. SPSS 11.5 statistic software was used to analyze the role of their abnormal expressions in AP.Results:There was statistical difference which in severity score of AP between SAP group and mild MAP group and NC group(P<0.05). there was statistical difference which in severity score of APACHEâ…¡,Ranson between MAP group and NC group(P<0.05).Fib in MAP group was significant difference compared with NC group(P<0.05);But PT,APTT, D-dimer in MAP group was not significant difference compared with NC group(P>0.05).Fib , D-dimer in SAP group was significant differences compared with NC group and MAP group(P<0.05).The correlativity of APACHEâ…¡evaluation score, Ranson evaluation score, CT score and Fib, D-dimer in AP is linear.Conclusion:The correlativity of APACHEâ…¡evaluation score, Ranson score ,CT score and Fib, D-dimer in AP is linear. D-dimer and Fibrinogen is very significance experiment index which early estimate the severity of AP. Monitoring the levels of D-dimer and Fibrinogen may be very useful in the evaluation of the severity and prognosis of AP.