The Value Of Substance P And Hydrogen Sulfide In Estimating The Severity Of Acute Pancreatitis

Objective:Acute pancreatitis refers to inflammation of the pancreas. The "gold standard" for diagnosis and/or assessment of severity of acute pancreatitis is still a problem. Because the disease may progress rapidly without apparent signs, the ideal marker would be the one that is measured rapidly and easily, recent studies in animals have suggested that inflammatory mediators substance P and hydrogen sulfide may play critical roles. This study will evaluate if substance P and hydrogen sulfide will be upregulated in the process of the disease, and if the levels of their elevation will predict the severity by combining with APACHE II score and CTSI score.Methods:48patients with acute pancreatitis from August2011to January2012in Xiangya Hospital were collected in this study. According to the clinical guidelines for acute pancreatitis in2007, the patients were divided into two groups:mild acute pancreatitis group and severe acute pancreatitis group.There are29cases in mild acute pancreatitis group and19in severe acute pancreatitis group. And twenty healthy persons were also included as the control group. CTSI score, APACHEII score and blood samples were obtained within24hours after admission.Blood samples were used to detect the concentrations of substance P and hydrogen sulfide.Results:1. The concentrations of substance P is higher in patients of severe acute panereatitis group than mild acute pancreatitis group(P=0.0105<0.05) and the control group(p<0.001); substance P level is higher in patients of mild acute panereatitis group than the control group (p<0.001).2. The concentrations of hydrogen sulfide is higher in patients of severe acute panereatitis group than mild acute pancreatitis group (P=0.009<0.05) and the control group(p<0.001), Hydrogen sulfide level is higher in patients of mild acute panereatitis group than the control group (p<0.001)3..Spearman's correlation coeffieient between substance P level and APACHEII score is0.286(P<0.05). Substance P level is positively correlated with the severity of acute pancreatitis. While substance P level is not correlated with CTSI score (P=0.056)4. Spearman's correlation coeffieient between hydrogen sulfide level and APACHEII score is0.674(P<0.01). hydrogen sulfide level is positively correlated with the severity of acute pancreatitis. While hydrogen sulfide level was not correlated with CTSI score (P=0.115)5. Substance P level is not correlated with hydrogen sulfide level (P=0.467)Conclusion:1. The Higher substance P level suggests the higher severity of the patients with acute panereatitis.2. The Higher hydrogen sulfide level suggests the higher severity of the patients with acute panereatitis.3. Substance P and hydrogen sulfide levels are correlated with the severity of AP.