| Objective Immune cells- inflammatory factor theory is considered plays an important role in the pathogenesis of acute pancreatitis.This Clinical studies were detected the dynamic changes of CD4+CD25+regulatory T cells and cytokines IL- 6, HGF and Ang- 2 levels in the peripheral blood of patients with acute pancreatitis. To preliminary investigate the CD4+CD25 +Foxp3+Treg, IL- 6, HGF and Ang- 2 dynamic evolution of clinical significance in acute pancreatitis.Methods 72 cases suffering from acute pancreatitis hospitalization continuously from April 2014 to October 2014 in suzhou university affiliated first people’s hospital were studied, according to the 2012 new Atlanta classification standards were divided into Mild acute pancreatitis(Mild acute pancreatitis, MAP) 54 cases, moderate severe acute pancreatitis(Moderately severe acute pancreatitis, MSAP) 12 cases,severe acute pancreatitis(severe acute pancreatitis, SAP) 6 cases and 30 cases of healthy people as control. Collect 1, 3, 7 days after admission in patients with peripheral venous blood of 5 ml, flow cytometry instrument detection percentage Treg cells, double antibody ELISA clamp method to detect serum cytokine IL- 6, HGF, Ang- 2 concentration. Combined with clinical data, preliminary analysis the clinical significance of these indicators in acute pancreatitis.Results(1)The peripheral blood CD4+CD25 +Foxp3+Treg cells of CD4+T cell percentage on 1,3,7 days were Respectively in severe acute pancreatitis(3.83%±0.89%,5.18%±1.17%,6.71%±1.38%),in moderate severe acute pancreatitis(3.27%±1.16%,4.24%±1.54%,5.09%±1.50%),in mild acute pancreatitis(2.80%±1.57%,3.66%±1.62%,2.26%±0.93%)and normal control(1.41%±0.72 %),The Treg percentage of MAP group were elevated on the first day, to spike on the third day, significantly decreased on the seventh day but still higher than that of healthy people, MASP group and SAP group characterized by increased gradually along with the course of the disease, each point SAP group compared with the MAP group and healthy control group have statistical significance difference(P < 0.05), the SAP group compared with MSAP group, withsignificant difference(P > 0.05). Treg percentage in accompanied by continuous organ failure was significantly higher than no organ failure, comparing accompanied by organ failure with no organ failure, each point have statistically significant differences(P < 0.05)。(2)The peripheral blood levels of IL- 6 on 1,3,7 days were Respectively in severe acute pancreatitis(30.47±23.01,37.63±14.22,34.29±16.02),in moderate severe acute pancreatitis(27.73±19.42,45.81±10.75,48.23±17.88),in mild acute pancreatitis(26.57±16.28,13.59±11.33,6.28±6.14)and normal control(5.20±13.07),on the first day MAP group was obviously higher, afterward gradually decline, MSAP group gradually increased on the first day to the seventh day, on the first day of the SAP group was obviously higher, the third day to spike, and the seventh day below the third day. On first day each AP groups respectively compared with control group, the difference is statistically significant(P < 0.01), the SAP group compared with the MAP group has statistically significant difference(P < 0.01),on third day and seventh day SAP group and MSAP group respectively compared with the MAP group and the control group, the difference is statistically significant(P < 0.01), on 1, 3, 7 days SAP group compared with the MSAP group, there were no statistically significant difference(P > 0.05). IL-6 in accompanied by continuous organ failure was significantly higher than no organ failure, comparing accompanied by organ failure with no organ failure, on first day and third day have statistically significant differences(P < 0.05), on seventh day have no statistically significant differences(P > 0.05).(3)The peripheral blood levels of HGF on 1,3,7days were respectively in severe acute pancreatitis(285.07±178.54,246.98±78.39,1073.39±438.76),in moderate severe acute pancreatitis(216.62±61.05,271.39±197.55,262.78±133.54),in mild acute pancreatitis( 178.58±72.92, 169.94±66.31, 132.93±48.38) and normal control(150.95±28.30),the MAP group was higher on the first day, afterward gradually decline, the MSAP group was obviously higher on the first day, the third day to the peak, on the seventh day is less lower than the third day, the first day of the SAP group was obviously higher, slightly lower on the third day, the seventh day increased more obviously than the first day. on 1, 3, 7 days SAP group respectively compared with the MAP and the control group, the differences were statistically significant(P < 0.05), the SAP group compared with the MSAP group, there was no statistically significant difference(P > 0.05), theMSAP compared with the MAP, there was no statistically significant difference(P > 0.05). HGF in accompanied by continuous organ failure was significantly higher than no organ failure, comparing accompanied by organ failure with no organ failure, on 1,3,7 days have statistically significant differences(P < 0.05).(4)The peripheral blood levels of Ang-2 on 1,3,7 days were respectively in severe acute pancreatitis(2389.04±189.71,1511.51±812.10,2217.58±242.18),in moderate severe acute pancreatitis(2171.40±436.58,2100.73±794.31,1438.86±175.60),in mild acute pancreatitis(1236.87±990.23,1031.22±900.60,999.30±1048.39)and normal control(827.98±108.03),the MAP group and the MSAP group were obviously higher on the first day, afterward gradually decline, the SAP group was obviously higher on the first day, slightly lower on the third day, rise again on the seventh day. On first and seventh days SAP group respectively compared with the MAP group and the control group, the differences were statistically significant(P < 0.05), on the third day the SAP group compared with the MAP group, there was no statistically significant difference(P > 0.05), the MSAP group respectively compared with the MAP group and the control group, the difference was statistically significant(P < 0.05), on 1, 3, 7 days SAP group compared with the MSAP group, there were no statistically significant difference(P > 0.05). ANG-2 in accompanied by continuous organ failure was significantly higher than no organ failure, comparing accompanied by organ failure with no organ failure, on first day and seventh day have statistically significant differences(P < 0.05), on third day have no statistically significant differences(P > 0.05)。Conclusion(1) Acute pancreatitis patients may exist the high Treg cells concentration in peripheral blood, That suggested there is an immune disorder in acute pancreatitis.(2) Acute pancreatitis patients may exist cytokines IL- 6, HGF, Ang- 2 high levels in peripheral blood, That suggested these cytokines may be associated with excessively inflammatory injury in acute pancreatitis. |
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