Preliminary Study Of T-lymphocyte Immune Function Changes Of Patients With Acute Pancreatitis

Objective:The study was aimed to measure T-lymphocyte immune function changes ofpatients with acute pancreatitis and to explore BISAP scoring system in clinicalapplications.Methods: To assess the severity and prognosis of acute pancreatitis by BISAP comparedwith Ranson scoring system and CTIS scoring system.According to BISAP scoringsystem, All people were divided as SAP or MAP patients.With FCM,we measure thepositive percentage of CD4~~+CD25~~+CD127~~+regulatory T cells,CD14~~+peripheral bloodmononuclear cell,CD64~~+polymorphonuclears and T lymphocytes subsets of whose SAPgroup(20patients)、MAP group(20patients) and healthy people group(20patients).Wemeasure serum IL-10and IL-4by ELISA. Statistical analysis was carried out with regardto data in different groups.Results:1.Among40patients with AP, there were20cases MAP and20cases SAP.BISAP scoring system scores of SAP patients significantly higher than these of MAPpatients, the results above were statistically significant (P <0.05). The AUC of BISAPscoring system scores was larger than that of CTSI and the Ranson scoring system, theAUC of BISAP,0.959(95%confidence interval [0.915,1.004]). BISAP scoring systemhas a good predictive ability of the severity of AP, its predictive ability of the localcomplications of AP was lower than CTSI scoring system.2.Comparing with control,there were statistical decrease of the percentage of CD3~~+、 CD4~+T lymphocytes、CD14~+PBMC, CD4~+/CD8~+in other two groups.Comparing withcontrol,there was statistical increase of the percentage of CD64~+PMN in other two groups,there were no difference in statistics above between SAP and MAP groups.There was nodifference in statistics in the percentage of CD4~+CD25~+CD127~+Treg of AP patientscomparing with control,but the expression of CD4~+CD25~+CD127~+Treg was higher in SAPgroup comparing with MAP group.The level of IL-4was higher in MAP groupcomparing with SAP and control groups.There were no difference in statistics in thepercentage of CD8~+T lymphocytes and the level of IL-10between three groups(P>0.05).Conclusion:1.BISAP scoring system has a good predictive ability of the severity of AP, its predictiveability of the local complications of AP was lower than CTSI scoring system. BISAP is anew simple and effective clinical scoring system to predict the severity of AP, it has agood reference value.2.In the immune disorders of AP pathogenesis reflect the body’s immunedysfunction.CD4~+CD25~+CD127~+Treg may promote the secretion of IL-4to playimmunosuppression.In SIRS stage,the expression of CD4~+CD25~+CD127~+Treg was higherin SAP group comparing with MAP group.