| Objective: SAP(Sever acute pancreatitis) is characteristic of acute onset,fast progression and dangerous pathogenetic condition, while multiple organ failure may happen early. Though many therapeutic measures are taken now , the death rate is still much high, and the pathogenesy of SAP is not distinct completely. SAP model was induced by retrograde injection of 5% sodium taurocholate to pancreatic duct. we detected the concentration change of Th1/Th2 cytokines in peripheral blood.,and studied the relation between Th1/Th2 cytokines and the severity degree and prognosis of SAP, as well as investigated the effect of Ulinastatin to Th1/Th2 cytokines.Methods: 112 health Wistar rat(all maleness, body weight 240±30g) were divided into 16 groups randomly,7 per group,that is:norm control group(A group),sham operation group (B group),SAP group(C group) and Ulinastatin intervention group(D group). B group was divided into 2h,6h,12h,24h groups and survival groups(marked with B1,B2,B3,B4 and Bsur respectively), likewise, C group and D group were divided into C1,C2,C3,C4,Csur and D1,D2,D3,D4,Dsur.SAP model was induced by retrograde injection of 5% sodium tanrocholate to pancreatic duct. Compared with SAP group , stomach and duodenum were flipped only and 5% sodium tanrocholate was not injected in sham operation group ,as well as ulinastatin was used immediately after anesthesia in Ulinastatin intervention group.Nothing was done in norm control group.Then, at 2h,6h,12h,24h the blood and pancreatic tissue were collected to detect Th1/Th2 cytokines by ELISA and necrosis grade by HE stainning. The quantity of ascites was measured , the amylase of blood and ascetes was detected and the life span of every survival groups was observed.Results:①At every time point,B group had no ascites, serum amylase,Th1,Th2 cytokines and the ratio of Th1/Th2 had no significant changes. Pancreatitic tissue had no edema, hemorrhage, necrosis and inflammatory cell infiltration by light microscope. And there were no death in postoperation two weeks.②C group: The quantity of hemorrhagic ascites increased gradually with time's passing and reached the peak at 24h(P<0.05 among 2h,6h,12h,but 24h compared with 12h,P=0.059>0.05),and so did ascetic amylase(P<0.05)and serum amylase(P<0.05 among 2h,6h,12h,but 24h compared with 12h, P=0.79>0.05).Th1 cytokines increased temperately compared with A group at 2h(P<0.05),but immediately decreased with time's passing(P < 0.05). Th2 cytokines increased temperately compared with A group at 2h(P=0.18>0.05),and after that, increased significantly(P < 0.05).The ratio of Th1/Th2 rose temperately compared with A group at 2h(P=0.082>0.05),then falled significantly with time's passing, even the ratio was inverted. Pancreatic tissue was edema, hemorrhage, necrosis and inflammatory cell infiltration by light microscope, and its severity degree rose with time's passing(P<0.05 among 2h,6h,12h,but P=0.091>0.05 at 24h compared with 12h),the life span of Csur group was 2.14±1.07d.③D group: The quantity of hemorrhagic ascites stepped up with time's passing(P<0.05), and so did ascetic amylase and serum amylase(P<0.05). Th1 cytokines increased temperately compared with A group at 2h(P<0.05),but immediately falled with time's passing(P<0.05), Th1 cytokines increased temperately with time's passing,but there was no significantly difference among 2h,6h and 12h(P>0.05)except between 24h and 12h. The ratio of Th1/Th2 rose with time's passing at 2h and 6h(P<0.05),then that was falled(P<0.05). Pancreatic tissue was edema, hemorrhage, necrosis and inflammatory cell infiltration by light microscope, and its severity degree rose with time's passing(P>0.05 among 2h,6h,12h,but P=0.091<0.05 at 24h compared with 12h),the life span of Csur group was 5.86±2.41d.④At the same time,D group was compared with C group: the quantity of ascites, ascetic amylase , serum amylase and pancreatic patho-score were smaller and the life span of Dsur was longer(P<0.05).Th1 cytokines rose(P<0.05), however Th2 cytokines falled(P>0.05 at 2h,P<0.05 at the rest time points),and the ratio of Th1/Th2 rose significantly(P<0.05),the polarization was reverted partly. Conclusion:1.With pathogenetic condition's aggravation, Th1 cytokines fall,but Th2 cytokines increase gradually and the ratio of Th1/Th2 falls, inclined to Th1 suppression and Th2 polarization in early SAP.2. The imbalance of Th1/Th2 is concerned with the severity of SAP and Correcting the imbalance of Th1/Th2 is maybe very valuable in lessening the progress of SAP.3. It is much significant to detect Th1/Th2 cytokines in evaluating the prognosis of SAP.
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